2017-06-21T19:26:18-05:00 2016-12-31 910189318 Moss Adams LLP 805 SW Broadway Ste 1200 Portland OR 97205 990 2016-01-01 453321455 Oregon's Health CO-OP OREG 6126299079 2501 SW 1st Avenue No 100 Portland OR 97201 Jan Moenck SPECIAL DEPUTY RECEIVER 6126299079 2017-06-21 1 Wendy Campos P00448102 5032421447 2017-06-14 12.129.7.100 2017-06-21 11:17:40 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 1133A14FFAB8169331CEB935F8079429E4018A44 2016 2021-01-29 14:40:06Z X JAN MOENCK 20 Batterson Park Rd 300 Farmington CT 06032 76664935 0 X WWW.OHCOOP.ORG X 2011 OR OREGON'S HEALTH CO-OP IS A NONPROFIT PUBLIC BENEFIT CORPORATION OPERATING EXCLUSIVELY AS A CONSUMER OPERATED AND ORIENTED HEALTH PLAN AS DEFINED UNDER SECTION 1322 OF THE AFFORDABLE CARE ACT. THE CORPORATION OFFERed HEALTH CARE INSURANCE AND SERVICES TO INDIVIDUALS AND BUSINESSES ON AND OFF THE OREGON HEALTH INSURANCE EXCHANGE. THE ORGANIZATION CEASED CONDUCTING OPERATIONS AS A HEALTH INSURANCE CARRIER AS OF JULY 31, 2016. EFFECTIVE JULY 11, 2016, OREGON'S HEALTH CO-OP WENT INTO STATE RECEIVERSHIP AND ALL POLICIES WERE TERMINATED AS OF JULY 31, 2016. on march 2, 2017 the organization entered into liquidation and WIND-DOWN OF THE OPERATIONS IS in process. X 0 0 51 12 0 0 0 0 53751482 48331347 283327 791462 0 0 54034809 49122809 0 0 0 0 3589402 4707678 0 0 0 68882488 71551746 72471890 76259424 -18437081 -27136615 45615668 16750410 81768357 81011335 -36152689 -64260925 X OREGON'S HEALTH CO-OP IS A NONPROFIT PUBLIC BENEFIT CORPORATION OPERATING EXCLUSIVELY AS A CONSUMER OPERATED AND ORIENTED HEALTH PLAN AS DEFINED UNDER SECTION 1322 OF THE AFFORDABLE CARE ACT. THE CORPORATION OFFERed HEALTH CARE INSURANCE AND SERVICES TO INDIVIDUALS AND BUSINESSES ON AND OFF THE OREGON HEALTH INSURANCE EXCHANGE. see also part III line 3 below. 0 1 OREGON'S HEALTH CO-OP, A NONPROFIT COMMERCIAL HEALTH INSURANCE ISSUER, ESTABLISHED TO OPERATE AS A CONSUMER OPERATED AND ORIENTED PLAN AS DEFINED BY THE AFFORDABLE CARE ACT (ACA), SOLD HEALTH INSURANCE COVERAGE TO INDIVIDUALS, SMALL GROUPS AND LARGE GROUPS, through july 31, 2016. see additional discussion for part III line 3 above. 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 2429 0 1 51 1 0 0 0 0 0 0 0 0 0 X 0 0 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 0 0 OR X JAN MOENCK 6126299079 2501 SW 1st Avenue 100 Portland OR 97201 Ira Zarov Chair until 7/8/16 5.00 X X 0 0 0 Susan King Secretary until 7/8/16 3.00 X X 0 0 0 Henry Chip Lazenby Director until 7/8/16 3.00 X 0 0 0 Erik Isaacman Director until 7/8/16 3.00 X 0 0 0 Hilary Bradbury Director until 7/8/16 3.00 X 0 0 0 Andrew Kyler Director until 7/8/16 3.00 X 0 0 0 Elle Abbott Director until 7/8/16 3.00 X 0 0 0 Keri Abbott Director until 7/8/16 3.00 X 0 0 0 Christine Ford Director until 7/8/16 3.00 X 0 0 0 Tom Gifford Director until 7/8/16 3.00 X 0 0 0 Debra McCurry Director until 7/8/16 3.00 X 0 0 0 Asawari Mokashi Director until 7/8/16 3.00 X 0 0 0 Phil Jackson President & CEO until 8/5/16 40.00 X 246274 0 18171 Peggy Worley CFO 40.00 X 195999 0 16590 Peggy Grunden TREASURER & CFO until 3/4/16 40.00 X 182987 0 9814 Colleen Nelson chief compliance officer 40.00 X 182531 0 16485 Robert Sumner Dir of Sales until 8/12/16 40.00 X 153588 0 12844 Jeff Markle dir mbr exp until 10/4/16 40.00 X 113433 0 14015 Jean Gargan Project Manager 40.00 X 102325 0 8006 1177137 0 95925 7 0 1 0 Valence Health 540 W Madison st Chicago IL 60661 Third-Party Admin Services 3137972 Risk Regulartory Consulting LLC 5155 Paysphere Circle Chicago IL 60674 Receivers 480936 Milliman 5415 E High St Suite 275 Phoenix AZ 85054 Actuarials 431222 MPX 2301 Congress St Portland ME 04102 Printing/Publishing 311203 Valley Insurance Professionals 5022 Commercial St SE salem OR 97306 Insurance Commissions 281654 11 premium revenue 524114 48331347 48331347 48331347 243920 243920 28083538 6130 27485004 57122 598534 -50992 547542 547542 49122809 48331347 0 791462 669836 2462729 94554 1246479 234080 5902012 234951 61012 1378293 258390 2702153 303079 42755 18175 221325 63999 167263 medical claims paid 65311339 Change in reserves -5113000 76259424 5097103 13212358 38811 5000 465694 211936 162280 117424 140031 44856 26211797 0 13662232 3276260 45615668 16750410 1497004 6125611 58856900 58856900 21414453 16028824 81768357 81011335 X 0 0 0 0 -36152689 -64260925 -36152689 -64260925 45615668 16750410 -27136615 119534 -1091155 0 X 0 0 0 162280 117424 44856 44856 Premiums Receivable 228111 Reinsurance Receivable 1667185 HEALTHCARE AND OTHER AMOUNTS RECEIVABLE 354483 Other non-invested assets 1026481 3276260 Premiums receIved in advance 570843 Healthcare Payables 15084522 Ceded Reinsurance Premiums Payable 243263 other liabilities 130196 16028824 X X 1 0 0 Phil Jackson President & CEO until 8/5/16 162899 0 82600 0 775 0 11369 0 6802 0 264445 0 0 0 Peggy Worley CFO 170824 0 20000 0 5175 0 7211 0 9379 0 212589 0 0 0 Peggy Grunden TREASURER & CFO until 3/4/16 47314 0 42388 0 93285 0 8702 0 1113 0 192802 0 0 0 Colleen Nelson chief compliance officer 177356 0 0 0 5175 0 7036 0 9450 0 199017 0 0 0 Robert Sumner Dir of Sales until 8/12/16 113688 0 39125 0 775 0 6323 0 6521 0 166432 0 0 0 Part I, Line 4a peggy grunden, treasurer & cfo until march 2016 - $93,285 publicly traded bond investments 2016-12-31 28083538 Investments were sold at FMV on the normal market n/a 0 0 0 0 Sch N Part II line 1 investments were sold at FMV on the normal market pursuant to a plan to liquidate the organization and pay obligations. Form 990, Part III, line 3 THE ORGANIZATION CEASED CONDUCTING OPERATIONS AS A HEALTH INSURANCE CARRIER AS OF JULY 31, 2016. EFFECTIVE JULY 11, 2016, OREGON'S HEALTH CO-OP WENT INTO STATE RECEIVERSHIP AND ALL POLICIES WERE TERMINATED AS OF JULY 31, 2016. on march 2, 2017 the organization entered into liquidation and WIND-DOWN OF THE OPERATIONS IS in process. Form 990, Part V, Line 13a OR Form 990, Part VI, Section A, line 1 the organization was in receivership at the end of 2016 as described in Part III and no board members were in existence at the end of the year. All typical board powers were transferred to Jan Moenck, the special deputy receiver, reported in part II as the signer of the return. Form 990, Part VI, Section A, line 6 oregon's health co-op had one class of members. Each individual over the age of 18 years who is covered under a health insurance policy issued by the corporation is qualified to be a member of the corporation. Since no policies have been issued, the bylaws name the Formational Board as interim qualified members. Form 990, Part VI, Section A, line 7a The Formational Board and all functions they performed were eliminated immediately prior to receivership on july 11, 2016. Form 990, Part VI, Section B, line 11b Oregon's health Co-Op's CFO and Receiver review the final Form 990 prior to filing. Form 990, Part VI, Section B, line 12c The conflict of interest policy, and its monitoring were the responsibility of the chair person of the board under normal operations, until receivership on july 11, 2016. Form 990, Part VI, Section B, line 15a THE ANNUAL COMPENSATION FOR Oregon's Health Co-op's CEO WAS DETERMINED BASED ON A MARKET STUDY OF COMPARABLE DATA last performed in 2015 AND APPROVED AND DOCUMENTED BY THE INDEPENDENT BOARD OF DIRECTORS. Form 990, Part VI, Section C, line 19 While no requirement to make its governance documents, conflict of interest policy and financial statements available to the public exists, Oregon's Health Co-op considered all requests for these documents on a case by case basis.