2017-05-11T15:49:35-05:00 2016-06-30 861065772 Deloitte Tax LLP 50 South Sixth Street Suite 2800 Minneapolis MN 55402 990 2015-07-01 450346132 Sanford Heart of America Health Plan SANF 7017765848 810 South Main Rugby ND 58368 JoAnn Kunkel Chief Financial Officer 6053331000 2017-05-11 1 Anne Fulton P00941863 6123974000 2015 2021-01-29 14:40:06Z Kelby Krabbenhoft 2301 East 60th St Sioux Falls SD 57104 5828276 0 X www.hoahp.com X 1978 ND To coordinate effective and efficient delivery of high-quality health care in a cost effective manner. 15 9 0 0 0 0 0 0 3543218 3911373 29251 39356 0 0 3572469 3950729 0 0 0 0 109084 99758 0 0 0 4253741 3955021 4362825 4054779 -790356 -104050 2316773 3551389 999117 1314504 1317656 2236885 X The Sanford Heart of America Health Plan is a rural, nonprofit health maintenance organization. Our mission is to coordinate effective and efficient delivery of high-quality health care in a cost effective manner. Member service is our priority. We are committed to the development of personal responsibility for a healthy lifestyle. 0 0 3935230 0 3911373 Sanford Heart of America Health Plan was incorporated for the purpose of providing comprehensive health care services on a prepaid basis and for the purpose of establishing and operating organized health maintenance and health care delivery systems.Sanford Heart of America Health Plan (SHAHP) served 328 Medicare members during fiscal year 2016 and 370 commercial and individual members. Through June 30, 2016, the following community services were provided:SHAHP hosted their annual Fun Walk event in August.Other miscellaneous items involved a sponsorship at a Turkey Trot event. 3935230 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 X 15 9 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X JoAnn Kunkel CFO 6053331000 2301 East 60th Street Sioux Falls SD 57104 X Barb Everist Trustee 0.10 1.40 X 0 0 0 Brent Teiken Trustee 0.10 1.40 X 0 0 0 David Beito Trustee 0.10 1.40 X 0 0 0 Don Jacobs Trustee 0.10 1.40 X 0 0 0 Don Morton Trustee 0.10 1.40 X 0 0 0 James Cain Trustee 0.10 1.40 X 0 0 0 Jim Entenman Trustee (thru Nov 15) 0.10 1.40 X 0 0 0 Lauris Molbert Trustee 0.10 1.40 X 0 0 0 Maria Bell MD Trustee/Sanford Physician 0.10 59.90 X 0 821799 37764 Mark Lundeen MD Trustee/Sanford Physician 0.10 59.90 X 0 948187 27126 Mark Paulson MD Trustee/Sanford Physician 0.10 59.90 X 0 234209 32587 Melissa Hinton Trustee 0.10 1.40 X 0 0 0 Michael LeBeau MD Trustee/Sanford Physician 0.10 59.90 X 0 1287761 30916 Patrick Durick Trustee 0.10 1.40 X 0 0 0 Richard Hardie MD Trustee/Sanford Physician (thru Nov 15) 0.10 59.90 X 0 624505 34022 Thomas Hruby Trustee 0.10 1.40 X 0 0 0 Kelby K Krabbenhoft Sanford President & CEO 0.10 59.90 X X 0 3896486 21654 Kelby K Krabbenhoft Deferred Comp Sanford President & CEO 0.10 59.90 X X 0 0 717699 JoAnn L Kunkel Chief Financial Officer 0.10 59.90 X 0 826615 33636 Ruth Krystopolski Exec VP Sanford Health Plan (thru Dec 15) 10.00 50.00 X 0 456262 34938 Cecily Tucker VP Finance Sanford Health Plan 10.00 50.00 X 0 294975 16000 0 9390799 986342 0 0 1 0 0 Premiums 524114 3262180 3262180 Medicare Reimbursement 524114 535858 535858 Reinsurance Recoveries 524114 113335 113335 3911373 40195 40195 1876708 1877547 -839 -839 -839 3950729 3911373 0 39356 76568 65083 11485 3443 2927 516 14464 12294 2170 5283 4490 793 96446 96446 52253 51915 338 5206 4425 781 23700 20145 3555 16500 14025 2475 2023 1719 304 201 171 30 3102 2637 465 Claims 3346642 3346642 Capitation Services 115802 115802 Reinsurance 68091 68091 Premiums Tax 60149 60149 164906 164715 191 4054779 3935230 119549 0 74776 856404 1613184 1633817 90028 488474 13442 10340 0 0 0 0 525343 562354 2316773 3551389 161188 247670 312586 504480 525343 562354 999117 1314504 X 1317656 2236885 1317656 2236885 2316773 3551389 X -104050 23279 1000000 X 0 1 X 1 0 0 Claims Payable 562354 562354 X Part X, Line 2: Certain controlled organizations are subject to income taxes. Deferred income tax assets and liabilities are recognized for the differences between the financial and income tax reporting basis of assets and liabilities based on enacted tax rates and laws. A tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination. The deferred income tax provision or benefit generally reflects the net change in deferred income tax assets and liabilities during the year. The current income tax provision reflects the tax consequences of revenues and expenses currently taxable or deductible on various income tax returns for the year reported. Sanford Heart of America Health Plan did not have an income tax liability at June 30, 2016; some related organizations have established reserves. 0 1 0 0 0 0 1 1 0 Maria Bell MD Trustee/Sanford Physician 0 767249 0 0 0 54550 0 13250 0 24514 0 859563 0 0 Mark Lundeen MD Trustee/Sanford Physician 0 849011 0 0 0 99176 0 13250 0 13876 0 975313 0 0 Mark Paulson MD Trustee/Sanford Physician 0 234209 0 0 0 0 0 11917 0 20670 0 266796 0 0 Michael LeBeau MD Trustee/Sanford Physician 0 1287761 0 0 0 0 0 10600 0 20316 0 1318677 0 0 Richard Hardie MD Trustee/Sanford Physician (thru Nov 0 618653 0 0 0 5852 0 13250 0 20772 0 658527 0 0 Kelby K Krabbenhoft Sanford President & CEO 0 1468928 0 2352758 0 74800 0 0 0 21654 0 3918140 0 0 Kelby K Krabbenhoft Deferred Comp Sanford President & CEO 0 0 0 0 0 0 0 717699 0 0 0 717699 0 0 JoAnn L Kunkel Chief Financial Officer 0 584610 0 165000 0 77005 0 11852 0 21784 0 860251 0 0 Ruth Krystopolski Exec VP Sanford Health Plan (thru De 0 399816 0 0 0 56446 0 13250 0 21668 0 491180 0 0 Cecily Tucker VP Finance Sanford Health Plan 0 254295 0 13100 0 27580 0 13250 0 2750 0 310975 0 0 Part I, Line 1a Certain items listed on Line 1a are provided by related organizations. Part I, Line 3 The Executive Compensation Committee of the Sanford Board of Trustees directly engages a nationally recognized independent compensation consulting firm annually to review the total compensation arrangements of the officers and executives of the organization, including the CEO, and to report the findings to them for deliberation and action. The deliberations and actions are recorded in the minutes of the Sanford Board of Trustees. The most recent study was completed in 2016. Part I, Line 4b Certain executives participate in a defined benefit SERP Plan. There were no individuals who received payments during the year. Part I, Line 6 Sanford physicians are compensated based on the professional services they perform within the clinic in which they provide care. Generally, the model is based on production. Part I, Line 7 Certain employees are eligible for a discretionary incentive bonus. Bonuses are paid based on the achievement of financial and other goals. Form 990, Part VI, Section A, line 2 The following officers, board members, and key employees are employees of Sanford or its related organizations. Many of these employees also serve on other related Sanford boards, or have business relationships with each other that span the organization as a whole: Maria Bell, Mark Lundeen, Mark Paulson, Michael LeBeau, Richard Hardie, Kelby Krabbenhoft, JoAnn Kunkel, Ruth Krystopolski and Cecily Tucker. Form 990, Part VI, Section A, line 6 Sanford Health Plan is the sole member of the organization. Form 990, Part VI, Section A, line 7a Board members are members of the Board of Directors of Sanford Health Plan. Form 990, Part VI, Section A, line 7b Sanford Health Plan, as sole member, reviews the actions of Sanford Heart of America Health Plan. Form 990, Part VI, Section B, line 11 The Form 990 is prepared internally by Finance and reviewed by executive management. An external accounting firm reviews the return and prepares return highlights and key disclosures for the Board of Trustees meeting prior to the return filing date. Before the return is filed, a complete copy is provided to the current Board of Trustees. Form 990, Part VI, Section B, line 12c The annual Conflict of Interest disclosure process is managed by the Chief Compliance Officer (CCO). The CCO is responsible for assuring that all completed forms are returned in a timely and complete manner. Conflict of Interest questionnaires are sent to System Trustees, members of the governing boards of subsidiary entities, officers and key employees for all the entities subject to the IRS Form 990 filings. The disclosures are summarized for review by the executive committee of the Board of Trustees, pursuant to policy. This review allows: 1) The Board to acquire an awareness of financial relationships of board members and key management employees and can invoke the recusal process on a case-by-case basis if potential conflicts are implicated in Board decisions and deliberations, and, 2) Gives the Board the opportunity to seek additional information and clarification about disclosures to determine potential conflicts of interest and how to manage them. Form 990, Part VI, Section B, line 15 A related party, Sanford Health, does have a process for determining compensation of the persons listed on Part VII Section A, including a review and approval by independent persons, review of comparability data and contemporaneous substantiation of the deliberation and decision for such compensation. The Executive Compensation Committee of the Sanford Board of Trustees directly engages a nationally recognized independent compensation consulting firm annually to review the total compensation arrangements of the officers and executives of the organization, including the CEO, and to report the findings to them for deliberation and action. The deliberations and actions are recorded in the minutes of the Sanford Board of Trustees. The most recent study was completed in 2016. Form 990, Part VI, Section C, line 19 Although the organization does not maintain a website where the public can access these documents, it would respond individually to any requests or inquiries from the public for these documents. Form 990, Part VII The Sanford Board of Trustees has ultimate governance responsibilities for each major operating entity within Sanford. In addition, a Board of Directors is established for each major operating entity. This Board has specific responsibilities delegated from the Board of Trustees. Generally these responsibilities are related to the oversight of the day to day operations of that entity. Form 990, Part XI, line 9: Transfer from related org (capital contribution) 1,000,000. Sanford 801 Broadway Drive Fargo ND 58122 271218956 Supporting Organization ND 501(c)(3) 11-II 0 Sanford Health Foundation 101 S Reid Street Sioux Falls SD 57103 363297853 Foundation SD 501(c)(3) 11-II Sanford Health 1 Edith Sanford Breast Cancer Foundation 101 S Reid Street Sioux Falls SD 57103 450404126 Foundation ND 501(c)(3) 11-II Sanford Health 1 F-M Ambulance Service Inc 2215 18th Street S Fargo ND 58103 450344371 EMT ND 501(c)(4) Sanford North 1 Sanford Health Foundation North PO Box 2010 Fargo ND 58122 450398104 Foundation ND 501(c)(3) 7 Sanford North 1 Sanford Health Foundation Hillsboro PO Box 609 Hillsboro ND 58045 363542187 Foundation ND 501(c)(3) 7 Sanford Hillsboro 1 Sanford Health Foundation of Northern Minnesota 1300 Anne Street NW Bemidji MN 56601 411389317 Foundation MN 501(c)(3) 11-II Sanford Health of Northern Minnesota 1 Sanford Health Foundation West 300 North 7th Street Bismarck ND 58501 450397196 Foundation ND 501(c)(3) 7 Sanford Bismarck 1 Medcenter One Inc Auxiliary 300 North 7th Street Bismarck ND 58501 237293043 Supporting Organization ND 501(c)(3) 11-I Sanford Bismarck 1 Sanford Health Foundation Thief River Falls 120 Labree Avenue S Thief River Falls MN 56701 411761135 Foundation MN 501(c)(3) 7 Sanford Medical Center Thief River Falls 1 National Student Housing-South Dakota LLC 100 S Phillips Ave Sioux Falls SD 57104 202129839 Investment SD N/A RAC Rentals LLC 100 S Phillips Ave Sioux Falls SD 57104 261961077 Investment SD N/A Sanford Home Medical Equipment Inc 2710 W 12th Street Sioux Falls SD 57105 460388597 Healthcare Equipment SD N/A C 1 Sanford Health Plan 300 Cherapa Place Sioux Falls SD 57103 911842494 Insurance SD N/A C 1 Sanford Health Plan of MN 300 Cherapa Place Sioux Falls SD 57103 460445852 Insurance MN N/A C 1 Sanford Frontiers 1305 W 18th Street PO Box 5039 Sioux Falls SD 571175039 455436599 Weight Loss/Fitness SD N/A C 1 SOB Inc 2701 S Minnesota Avenue Suite 2 Sioux Falls SD 57105 460442628 Air Transportation SD N/A C 1 Sanford Affiliated Services Inc 300 N 7th Street Bismarck ND 58501 450403146 Investment Activity ND N/A C 1 Sanford World Clinics - Ghana Sarbah Road Tantri Lorry Station Cape Coast GH Healthcare GH N/A C 1 Shanghai Sanford Healthcare Management Consulting Co Ltd 188 Yesheng Road Room A-862 Guoma Shanghai CH Healthcare CH N/A C 1 Sanford International - Munich GmbH Nymphenburger Strasse 3 Munich GM Healthcare GM N/A C 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Sanford Health Plan C 1000000 Cash