CHP OF WASHINGTON: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- CHP OF WASHINGTON (EIN 91-1729710)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-14
- IRS object ID
- 201713189349306406
- Schema version
- 2016v3.0
- 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 | 2017-11-14T14:04:56-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Moss Adams LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2707 Colby Avenue Suite 801 | AddressLine1Txt |
| City | Everett | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 911729710 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Community Health Plan of Washington | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 2065218833 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 3rd Avenue No 400 | AddressLine1Txt |
| City | Seattle | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98101 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Leanne Berge | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 2065218833 | PhoneNum |
| Signature | 2017-09-28 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Robert Grannum | PreparerPersonNm |
| PTIN | P00355876 | PTIN |
| Phone | 4252597227 | PhoneNum |
| Preparation | 2017-09-28 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 12.129.7.100 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-09-28 | IPDt |
| IP Tm | 19:54:03 | IPTm |
| IP Timezone | PD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 7ABEDE2D465AB02E671AD8304780CB1E1B9D70B4 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Principal Officer | Leanne Berge | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 3rd Avenue No 400 | AddressLine1Txt |
| City | Seattle | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,179,895,888 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | WWW.CHPW.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1996 | FormationYr |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Activity Or Mission | DELIVER MANAGED CARE SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 20 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 20 | VotingMembersIndependentCnt |
| Total Employee | 442 | TotalEmployeeCnt |
| Total Volunteers | 1 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,070,237,192 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,070,899,800 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,172,616 | PYInvestmentIncomeAmt |
| CY Investment Income | $8,551,795 | CYInvestmentIncomeAmt |
| PY Other Revenue | $10,353,891 | PYOtherRevenueAmt |
| CY Other Revenue | $17,512 | CYOtherRevenueAmt |
| PY Total Revenue | $1,084,763,699 | PYTotalRevenueAmt |
| CY Total Revenue | $1,079,469,107 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $36,506,208 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $39,200,235 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,008,619,818 | PYOtherExpensesAmt |
| CY Other Expenses | $1,022,837,371 | CYOtherExpensesAmt |
| PY Total Expenses | $1,045,126,026 | PYTotalExpensesAmt |
| CY Total Expenses | $1,062,037,606 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $39,637,673 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $17,431,501 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $502,034,871 | TotalAssetsBOYAmt |
| Total Assets EOY | $445,165,163 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $362,999,897 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $283,154,011 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $139,034,974 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $162,011,152 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To deliver accessible managed care services which meet the needs and improve the health of our communities, and make managed care participation beneficial for community-responsive providers. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $968,780,947 | ExpenseAmt |
| Revenue | $1,070,917,312 | RevenueAmt |
| Desc | The Plan provides health insurance coverage to enrollees of the Washington State Health Care Authority's (HCA) managed Medicaid and managed care service programs: Apple Health Family (AHF), State Children's Health Insurance Program (SCHIP), Apple Health Blind and Disabled (AHBD), Apple Health Expansion (AHE), and Behavioral Health Services Only (BHSO). In addition, the Plan provides health insurance for individuals covered through the state-based Health Insurance Marketplace (the Exchange) called Community HealthEssentials Plus. Community HealthEssentials Plus is offered by the Plan and administered by First Choice Health. The Plan also provides health insurance coverage to enrollees of the Centers for Medicare and Medicaid Services (CMS) Medicare Advantage (MA) Community HealthFirst program. | Desc |
| Total Program Service Expenses | $968,780,947 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | 0 | DescribedInSection501c3Ind |
| Schedule B Required | 0 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | 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 | 0 | 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | 0 | RelatedOrganizationCtrlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 3957 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 442 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 20 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 20 | 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 | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Stacy Kessel | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2065218833 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 3rd Avenue No 400 | AddressLine1Txt |
| City | Seattle | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (41 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Sheila Chilson | |||||||||
| Board Chair | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Steve Clark | |||||||||
| Board Vice Chair | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Carla M DewBerry | |||||||||
| Secretary | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| David Flentge | |||||||||
| Treasurer | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Jennifer Kriedler-Moss | |||||||||
| Board Member | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Teresita Batayola | |||||||||
| Board Member | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Dian Cooper | |||||||||
| Board Member | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Jennifer Robinson | |||||||||
| Board Member | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Cristobal Guillen | |||||||||
| Board Member | 1.00 | 1.00 | Yes (X) | $0 | $10,800 | $0 | |||
| Jesus Hernandez | |||||||||
| Board Member | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Aaron Wilson | |||||||||
| Board Member | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Linda McVeigh | |||||||||
| Board Member | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Anita Monoian | |||||||||
| Board Member | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Michael Erikson | |||||||||
| Board Member | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Desmond Skubi | |||||||||
| Board Member | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Desiree Sweeney | |||||||||
| Board Member | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Thomas Trompeter | |||||||||
| Board Member | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Michael Maples | |||||||||
| Board Member | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Juan Carlos Olivares | |||||||||
| Board Member | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Michael Leong | |||||||||
| Board Member | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Heather Findlay | |||||||||
| Board Member (through 1/16) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Mark Secord | |||||||||
| Board Member (through 1/16) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Juan Cordova | |||||||||
| Board Member (through 3/16) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Bob Rubin | |||||||||
| Board Member (through 9/16) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Diana Bader | |||||||||
| Board Member (through 6/16) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Leanne Berge | |||||||||
| Chief Executive Officer | 27.00 | 13.00 | Yes (X) | $22,788 | $0 | $3,631 | |||
| Lance Hunsinger | |||||||||
| CEO (through 8/16) | 27.00 | 13.00 | Yes (X) | $668,027 | $0 | $62,743 | |||
| Victor Collymore | |||||||||
| Chief Medical Officer | 27.00 | 13.00 | Yes (X) | $514,519 | $0 | $63,212 | |||
| Stacy Kessel | |||||||||
| Chief Financial Officer | 27.00 | 13.00 | Yes (X) | $446,510 | $0 | $47,194 | |||
| Marilee McGuire | |||||||||
| COO, Interim CEO 8/16-11/16 | 27.00 | 13.00 | Yes (X) | $567,718 | $0 | $45,570 | |||
| Alan Lederman | |||||||||
| Chief Administrative Officer | 27.00 | 13.00 | Yes (X) | $446,518 | $0 | $40,740 | |||
| Collin Foulds | |||||||||
| VP, General Counsel | 27.00 | 13.00 | $228,282 | $0 | $32,756 | Yes (X) | |||
| Pamela Sullivan | |||||||||
| VP of Talent & Bus. Proc. Mgmt | 36.00 | 4.00 | $252,804 | $0 | $37,833 | Yes (X) | |||
| Stephen Swanson | |||||||||
| VP, Information Technology | 40.00 | 0.00 | $236,990 | $0 | $31,047 | Yes (X) | |||
| Michael Evans | |||||||||
| VP, Customer Experience | 27.00 | 13.00 | $250,176 | $0 | $37,586 | Yes (X) | |||
| Abie Castillo | |||||||||
| SVP of Provider Serv/Network Dev. | 27.00 | 13.00 | $323,803 | $0 | $44,755 | Yes (X) | |||
| Kathy Brostoff | |||||||||
| Senior Med Dir. (through 10/16) | 32.00 | 8.00 | $205,767 | $0 | $52,262 | Yes (X) | |||
| Robert Bray | |||||||||
| VP Sales & Marketing | 26.00 | 14.00 | $243,137 | $0 | $28,325 | Yes (X) | |||
| Marie Faulring | |||||||||
| Director of Finance | 29.00 | 11.00 | $201,346 | $0 | $30,550 | Yes (X) | |||
| Yusuf Rashid | |||||||||
| Director of Pharmacy | 27.00 | 13.00 | $199,251 | $0 | $22,435 | Yes (X) | |||
| David Digiuseppe | |||||||||
| VP, Population Health Management | 20.00 | 20.00 | $204,206 | $0 | $30,839 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,011,842 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $10,800 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $611,478 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 15 | 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 |
|---|---|---|---|---|---|
| SYSTEMS SOURCE INC | |||||
| 3161 MICHELSON DRIVE STE 110 | IRVINE | CA | 92612 | FACILITIES CONTRACTING | $1,573,036 |
| Arcadia Solutions LLC | |||||
| 20 Blanchard Rd Ste 10 | Burlington | MA | 01803 | software consulting | $1,280,159 |
| KForce Professional Staffing | |||||
| PO Box 277997 | Atlanta | GA | 30384 | IT Consulting | $845,416 |
| PERKINS COIE LLP | |||||
| 1201 THIRD AVENUE STE 4800 | SEATTLE | WA | 98101 | LEGAL CONSULTING | $557,909 |
| Datec INCORPORATED | |||||
| 364 upland drive | seattle | WA | 98188 | It Consulting | $547,366 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 16 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Premium Earned | Desc |
| Business | 524114 | BusinessCd |
| Total Revenue Column | $1,070,899,800 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,070,899,800 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,070,899,800 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,644,975 | TotalRevenueColumnAmt |
| Exclusion | $6,644,975 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $102,309,979 | SecuritiesAmt |
| Other | $23,622 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $99,997,981 | SecuritiesAmt |
| Other | $428,800 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,311,998 | SecuritiesAmt |
| Other | -$405,178 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,906,820 | TotalRevenueColumnAmt |
| Exclusion | $1,906,820 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Other Income | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $17,512 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,512 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $17,512 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,079,469,107 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,070,917,312 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $8,551,795 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,405,202 | TotalAmt |
| Management And General | $4,405,202 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,690,926 | TotalAmt |
| Program Services | $2,991,188 | ProgramServicesAmt |
| Management And General | $28,699,738 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,018,107 | TotalAmt |
| Program Services | $381,792 | ProgramServicesAmt |
| Management And General | $636,315 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,086,000 | TotalAmt |
| Program Services | $335,769 | ProgramServicesAmt |
| Management And General | $1,750,231 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,255,329 | TotalAmt |
| Management And General | $1,255,329 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,528,804 | TotalAmt |
| Management And General | $4,528,804 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,547,484 | TotalAmt |
| Program Services | $14,024,898 | ProgramServicesAmt |
| Management And General | $17,522,586 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,252,065 | TotalAmt |
| Management And General | $1,252,065 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,054,944 | TotalAmt |
| Program Services | $174,928 | ProgramServicesAmt |
| Management And General | $1,880,016 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $327,964 | TotalAmt |
| Management And General | $327,964 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,805,937 | TotalAmt |
| Management And General | $3,805,937 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $529,844 | TotalAmt |
| Program Services | $11,105 | ProgramServicesAmt |
| Management And General | $518,739 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,131,263 | TotalAmt |
| Program Services | $1,131,263 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,562,326 | TotalAmt |
| Program Services | $363,631 | ProgramServicesAmt |
| Management And General | $5,198,695 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $404,766 | TotalAmt |
| Program Services | $13,565 | ProgramServicesAmt |
| Management And General | $391,201 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical and hospital ex | $949,349,296 | $949,349,296 | |
| Taxes, Licenses, and fe | $20,655,951 | $20,655,951 | |
| Boards, Bureaus and Ass | $221,498 | $3,512 | $217,986 |
| Collection and Bank ser | $209,900 | $209,900 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,062,037,606 | TotalAmt |
| Program Services | $968,780,947 | ProgramServicesAmt |
| Management And General | $93,256,659 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $185,259,381 | BOYAmt |
| EOY | $142,720,982 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $71,125,728 | BOYAmt |
| EOY | $27,996,607 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,527,307 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,698,700 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $627,919 | BOYAmt |
| EOY | $828,607 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $243,664,011 | BOYAmt |
| EOY | $272,168,842 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,357,832 | BOYAmt |
| EOY | $1,450,125 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $502,034,871 | BOYAmt |
| EOY | $445,165,163 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $362,999,897 | BOYAmt |
| EOY | $283,154,011 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $362,999,897 | BOYAmt |
| EOY | $283,154,011 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,738,448 | BOYAmt |
| EOY | $14,738,448 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $124,296,526 | BOYAmt |
| EOY | $147,272,704 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $139,034,974 | BOYAmt |
| EOY | $162,011,152 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $502,034,871 | BOYAmt |
| EOY | $445,165,163 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $17,431,501 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $6,266,203 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$721,526 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Other | Yes (X) | MethodOfAccountingOtherInd |
| 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 D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,527,307 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,698,700 | DepreciationAmt |
| Book Value | $828,607 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $828,607 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $1,079,469,107 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $1,079,469,107 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $1,079,469,107 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,062,037,606 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,062,037,606 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $1,062,037,606 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | As of December 31, 2016 and 2015, the Company has no uncertain tax positions, and in accordance with accounting guidance, has not recorded a contingent liability. There are no tax positions for which management believes it is reasonably possible that the total amount of tax contingencies will significantly increase or decrease within 12 months of the reporting date. The company files an exempt organization return with the U.S. federal jusrisdiction annually. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 (15 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Lance Hunsinger | ||||||||||||||
| CEO (through 8/16) | $668,027 | $0 | $0 | $0 | $0 | $0 | $15,900 | $0 | $46,843 | $0 | $730,770 | $0 | $0 | $0 |
| Victor Collymore | ||||||||||||||
| Chief Medical Officer | $423,761 | $0 | $90,758 | $0 | $0 | $0 | $15,900 | $0 | $47,312 | $0 | $577,731 | $0 | $0 | $0 |
| Stacy Kessel | ||||||||||||||
| Chief Financial Officer | $365,378 | $0 | $81,132 | $0 | $0 | $0 | $15,900 | $0 | $31,294 | $0 | $493,704 | $0 | $0 | $0 |
| Marilee McGuire | ||||||||||||||
| COO, Interim CEO 8/16-11/16 | $484,123 | $0 | $83,595 | $0 | $0 | $0 | $15,900 | $0 | $29,670 | $0 | $613,288 | $0 | $0 | $0 |
| Alan Lederman | ||||||||||||||
| Chief Administrative Officer | $370,713 | $0 | $75,805 | $0 | $0 | $0 | $15,900 | $0 | $24,840 | $0 | $487,258 | $0 | $0 | $0 |
| Collin Foulds | ||||||||||||||
| VP, General Counsel | $202,929 | $0 | $25,353 | $0 | $0 | $0 | $7,324 | $0 | $25,432 | $0 | $261,038 | $0 | $0 | $0 |
| Pamela Sullivan | ||||||||||||||
| VP of Talent & Bus. Proc. Mgmt | $217,933 | $0 | $34,871 | $0 | $0 | $0 | $12,539 | $0 | $25,294 | $0 | $290,637 | $0 | $0 | $0 |
| Stephen Swanson | ||||||||||||||
| VP, Information Technology | $199,580 | $0 | $37,410 | $0 | $0 | $0 | $14,496 | $0 | $16,551 | $0 | $268,037 | $0 | $0 | $0 |
| Michael Evans | ||||||||||||||
| VP, Customer Experience | $212,424 | $0 | $37,752 | $0 | $0 | $0 | $12,746 | $0 | $24,840 | $0 | $287,762 | $0 | $0 | $0 |
| Abie Castillo | ||||||||||||||
| SVP of Provider Serv/Network Dev. | $269,813 | $0 | $53,990 | $0 | $0 | $0 | $15,900 | $0 | $28,855 | $0 | $368,558 | $0 | $0 | $0 |
| Kathy Brostoff | ||||||||||||||
| Senior Med Dir. (through 10/16) | $156,703 | $0 | $49,064 | $0 | $0 | $0 | $15,523 | $0 | $36,739 | $0 | $258,029 | $0 | $0 | $0 |
| Robert Bray | ||||||||||||||
| VP Sales & Marketing | $208,414 | $0 | $34,723 | $0 | $0 | $0 | $11,829 | $0 | $16,496 | $0 | $271,462 | $0 | $0 | $0 |
| Marie Faulring | ||||||||||||||
| Director of Finance | $172,764 | $0 | $28,582 | $0 | $0 | $0 | $10,674 | $0 | $19,876 | $0 | $231,896 | $0 | $0 | $0 |
| Yusuf Rashid | ||||||||||||||
| Director of Pharmacy | $168,696 | $0 | $30,555 | $0 | $0 | $0 | $10,610 | $0 | $11,825 | $0 | $221,686 | $0 | $0 | $0 |
| David Digiuseppe | ||||||||||||||
| VP, Population Health Management | $174,118 | $0 | $30,088 | $0 | $0 | $0 | $12,562 | $0 | $18,277 | $0 | $235,045 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 3 | FormAndLineReferenceDesc |
| Explanation | The CHPW CEO Compensation is set by the executive committee of the CHPW board of directors based upon independent third party compensation information and professional opinion. The Board reviewed a CEO compensation analysis in June 2016, and then approved the CEO compensation at the time the CEO was hired. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | Description of classes of members or stockholders: The organization has one corporate member, community health network of Washingtion (CHNW), a related 501(c)(4) Tax exempt entity. |
| Form 990, Part VI, Section A, line 7a | The board of directors of the sole corporate member, Community Health Network of Washington (CHNW), elects the board of directors. Each member of the board of directors must meet the qualifications to be a CHNW Board Member. During 2016, All CHPW Board members served on the CHNW Board. |
| Form 990, Part VI, Section A, line 7b | The following powers related to CHPW are reserved to CHNW by its bylaws: A) Amendment of the Articles of Incorporation, B) Amendment to the Bylaws, C) Removal of one or more directors from the board, D) Approval of Articles of merger, E) Approval of the sale or lease of all or substantially all of the assets of CHPW other than in the ordinary course of business, and F) Approval of the voluntary dissolution of CHPW. |
| Form 990, Part VI, Section B, line 11b | THE 990 AND ALL REQUIRED SCHEDULES ARE REVIEWED BY THE VP OF FINANCE, CHIEF FINANCIAL OFFICER, AND CHIEF EXECUTIVE OFFICER. THE CHIEF FINANCIAL OFFICER THEN PRESENTS IT TO THE CHPW FINANCE COMMITTEE AND THE CHPW BOARD OF DIRECTORS FOR REVIEW BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. |
| Form 990, Part VI, Section B, line 12c | Description of the process to monitor transactions for conflicts of interest All directors, officers, and senior employees are required to annually disclose potential conflicts of interest with respect to board members. Potential conflicts are disclosed prior to deliberations; if an actual conflict exists, the individual with the conflict will not participate and is asked to leave the meeting during final deliberations and vote. Employees are governed by the organization's conflict of interest policy; actual or potential conflicts must be disclosed to human resources department or corporate compliance officer. The compliance officer, in cooperation with human resources, will review the conflict and advise the employee with potential conflict convening any limitations they must observe in regards to the conflict of interest. |
| Form 990, Part VI, Section B, line 15 | The CHPW CEO Compensation is set by the executive committee of the CHPW board of directors based upon independent third party compensation information and professional opinion. The Board reviewed a CEO compensation analysis in June 2016, and then approved the CEO compensation at the time the CEO was hired. At least annually, the CHPW human resources department reviews compensation of all employees (including employed officers and key employees). The CHPW human resources department utilizes several independent third party compensation surveys to make recommendations about employed officer and key employee compensation. Utilizing that information, the CHPW CEO sets the compensation for employed officers and key employees. |
| Form 990, Part VI, Section C, line 19 | Copies of governance documents, conflicts of interest policy, and financial statements are available by request made to the corporate offices at 1111 3rd Avenue, Suite 400 Seattle, WA 98101 or by faxing a request to (206) 521-8834. Also, the statutory audited financial statements are posted on the office of insurance commissioner website. |
| Form 990, Part VII, Board Compensation: | The following individuals serve on the board of Community Health Plan of Washington (CHPW) in connection with their roles as the CEO or Executive Director of the tax-exempt community health center or clinic (CHC) members of Community Health Network of Washington. These individuals do not receive compensation for their board service; however, CHPW pays their respective CHC a stipend for services on Board Committees and reimbursement for travel expenses. - Sheila Chilson - Steve Clark - David Flentge - Jennifer Krider-Moss - Teresita Batayola - Dian Cooper - Jennifer Robinson - Jesus Hernandez - Aaron Wilson - Linda McVeigh - Anita Monoian - Michael Erikson - Desmond Skubi - Desiree Sweeney - Thomas Trompeter - Michael Maples - Juan Carlos Olivares - Michael Leong |
| Form 990, Part XI, line 9: | Change in nonadmitted assets -721,526. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Community Health network of Washington | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 3rd Avenue Suite 400 | AddressLine1Txt |
| City | Seattle | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 911577184 | EIN |
| Primary Activities | HealthCare | PrimaryActivitiesTxt |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(4) | ExemptCodeSectionTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| 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 | 0 | 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 | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |