SCAN HEALTH PLAN ARIZONA: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- SCAN HEALTH PLAN ARIZONA (EIN 73-1729007)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-04
- IRS object ID
- 201643099349301779
- Schema version
- 2015v2.1
- 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 | 2016-11-04T17:31:45-05:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BDO USA LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 ANTON BLVD STE 500 | AddressLine1Txt |
| City | COSTA MESA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92626 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 731729007 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SCAN HEALTH PLAN ARIZONA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % VIRGINIA HAVAI | InCareOfNm |
| Business Name Control | SCAN | BusinessNameControlTxt |
| Phone | 5629895100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3800 KILROY AIRPORT WAY SUITE 100 | AddressLine1Txt |
| City | LONG BEACH | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 908065616 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | VINOD MOHAN | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5629895100 | PhoneNum |
| Signature | 2016-11-02 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | WALTER H HICK JR | PreparerPersonNm |
| PTIN | P01070437 | PTIN |
| Phone | 7149573200 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CHRISTOPHER WING | 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 | 90806 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $72,814,422 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | WWW.SCANHEALTHPLAN.COM/ARIZONA/MEDICARE/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2006 | FormationYr |
| Legal Domicile State | AZ | LegalDomicileStateCd |
| Activity Or Mission | TO SERVE AND TO IMPROVE THE LIVES OF THE FRAIL, ELDERLY AND DISABLED RESIDENTS OF ARIZONA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 3 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 16 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $159,090,188 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $72,675,105 | CYProgramServiceRevenueAmt |
| PY Investment Income | $75,286 | PYInvestmentIncomeAmt |
| CY Investment Income | $51,071 | CYInvestmentIncomeAmt |
| PY Other Revenue | $50,025,148 | PYOtherRevenueAmt |
| CY Other Revenue | -$13,790 | CYOtherRevenueAmt |
| PY Total Revenue | $209,190,622 | PYTotalRevenueAmt |
| CY Total Revenue | $72,712,386 | 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 | $1,535,288 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $841,134 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $165,171,838 | PYOtherExpensesAmt |
| CY Other Expenses | $67,028,372 | CYOtherExpensesAmt |
| PY Total Expenses | $166,707,126 | PYTotalExpensesAmt |
| CY Total Expenses | $67,869,506 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $42,483,496 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,842,880 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $27,766,641 | TotalAssetsBOYAmt |
| Total Assets EOY | $34,226,665 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,693,469 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,324,573 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $21,073,172 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $25,902,092 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO SERVE AND IMPROVE THE LIVES OF THE FRAIL, ELDERLY AND DISABLED RESIDENTS OF ARIZONA BY PROVIDING MEDICAL AND PHARMACY SERVICES, COORDINATED CARE, SOCIAL SERVICES AND OTHER SERVICES TO A GERIATRIC POPULATION THAT IS UNDERSERVED AND AT RISK. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | Yes (true) | SignificantChangeInd |
| Expense | $62,332,722 | ExpenseAmt |
| Revenue | $72,675,105 | RevenueAmt |
| Desc | Program Services Description provided in Schedule O | Desc |
| Total Program Service Expenses | $62,332,722 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | false | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 324 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 16 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 3 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | AZ | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | VIRGINIA HAVAI | PersonNm |
| Phone | 5629895100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3800 KILROY AIRPORT WAY SUITE 100 | AddressLine1Txt |
| City | LONG BEACH | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90806 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 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 |
|---|---|---|---|---|---|---|---|---|---|
| CHRISTOPHER WING | |||||||||
| DIRECTOR/CHAIRMAN | 2.0 | 38.0 | Yes (X) | Yes (X) | $0 | $1,061,356 | $1,181,020 | ||
| CATHERINE BATTEER | |||||||||
| DIRECTOR/PRESIDENT | 2.0 | 38.0 | Yes (X) | Yes (X) | $0 | $467,445 | $349,870 | ||
| WILLIAM ROTH | |||||||||
| DIRECTOR | 2.0 | 38.0 | Yes (X) | $0 | $657,812 | $614,955 | |||
| VINOD MOHAN | |||||||||
| CHIEF FINANCIAL OFFICER | 2.0 | 38.0 | Yes (X) | $0 | $559,982 | $458,685 | |||
| JANET KORNBLATT | |||||||||
| SECRETARY | 2.0 | 38.0 | Yes (X) | $0 | $407,978 | $365,095 | |||
| WENDY KARSTEN | |||||||||
| OUTGOING VP GENERAL MANAGER | 40.0 | 0.0 | $180,335 | $0 | $1,986 | Yes (X) | |||
| RICHARD PEITZMEIER | |||||||||
| VICE PRESIDENT - SALES | 40.0 | 0.0 | $244,717 | $0 | $110,017 | Yes (X) | |||
| KAREN SUGANO | |||||||||
| CORPORATE VP GENERAL MANAGER | 8.0 | 32.0 | $0 | $367,201 | $66,628 | Yes (X) | |||
| RUSSELL BROWER | |||||||||
| CHIEF MEDICAL DIRECTOR | 1.0 | 39.0 | $0 | $381,114 | $137,020 | Yes (X) | |||
| ANDREW WHITELOCK | |||||||||
| CHIEF RISK EXECUTIVE | 8.0 | 32.0 | $0 | $267,022 | $22,122 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $425,052 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,169,910 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $3,307,398 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HEALTHCARE PARTNERS ARIZONA LLC | |||||
| 19191 S VERMONT AVENUE STE 200 | TORRANCE | CA | 90502 | MEDICAL SERVICES | $18,779,697 |
| EXPRESS SCRIPTS INC | |||||
| 21653 NETWORK PLACE | CHICAGO | IL | 606731216 | MEDICAL SERVICES | $15,134,046 |
| LIFEPRINT ARIZONA | |||||
| PO BOX 46770 | LAS VEGAS | NV | 89114 | MEDICAL SERVICES | $33,783,096 |
| Professional Healthcare Network LL | |||||
| 7600 NORTH 16th ST STE 140 | PHOENIX | AZ | 85020 | MEDICAL SERVICES | $350,390 |
| AMERICAN HEALTHWAYS SERVICES | |||||
| 1445 S SPECTRUM BLVD SUITE 100 | CHANDLER | AZ | 92307 | MEDICAL SERVICES | $279,976 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MEDICARE PREMIUMS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $72,675,105 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $72,675,105 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $72,675,105 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $61,361 | TotalRevenueColumnAmt |
| Exclusion | $61,361 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $77,956 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $91,746 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$13,790 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$13,790 | TotalRevenueColumnAmt |
| Exclusion | -$13,790 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $10,290 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$10,290 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$10,290 | TotalRevenueColumnAmt |
| Exclusion | -$10,290 | ExclusionAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $72,712,386 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $72,675,105 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $37,281 | 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 | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $537,010 | TotalAmt |
| Management And General | $537,010 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $154,359 | TotalAmt |
| Management And General | $154,359 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,795 | TotalAmt |
| Management And General | $35,795 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,354 | TotalAmt |
| Management And General | $56,354 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,616 | TotalAmt |
| Management And General | $57,616 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,264,854 | TotalAmt |
| Management And General | $2,264,854 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,239 | TotalAmt |
| Management And General | $13,239 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,134 | TotalAmt |
| Management And General | $68,134 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,000 | TotalAmt |
| Management And General | $26,000 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,258,644 | TotalAmt |
| Program Services | $62,332,722 | ProgramServicesAmt |
| Management And General | $1,925,922 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $175,357 | TotalAmt |
| Management And General | $175,357 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,986 | TotalAmt |
| Management And General | $24,986 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,005 | TotalAmt |
| Management And General | $4,005 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,193 | TotalAmt |
| Management And General | $85,193 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,917 | TotalAmt |
| Management And General | $39,917 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,050 | TotalAmt |
| Management And General | $1,050 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,292 | TotalAmt |
| Management And General | $49,292 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|
| LICENSE AND PERMITS | $6,748 | $6,748 |
| FEDERAL, STATE, COUNTY TAXES | $5,600 | $5,600 |
| ALL OTHER EXPENSES | $5,353 | $5,353 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,869,506 | TotalAmt |
| Program Services | $62,332,722 | ProgramServicesAmt |
| Management And General | $5,536,784 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $110,147 | BOYAmt |
| EOY | -$80,496 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,480,186 | BOYAmt |
| EOY | $29,974,001 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,187,902 | BOYAmt |
| EOY | $2,634,262 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,878 | BOYAmt |
| EOY | $15,375 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $38,649 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $38,649 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $74,828 | BOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,613,273 | BOYAmt |
| EOY | $1,588,043 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $270,427 | BOYAmt |
| EOY | $95,480 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,766,641 | BOYAmt |
| EOY | $34,226,665 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,367,343 | BOYAmt |
| EOY | $8,258,013 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,881 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $311,245 | BOYAmt |
| EOY | $66,560 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,693,469 | BOYAmt |
| EOY | $8,324,573 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,073,172 | BOYAmt |
| EOY | $25,902,092 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,073,172 | BOYAmt |
| EOY | $25,902,092 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,766,641 | BOYAmt |
| EOY | $34,226,665 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $4,842,880 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$13,960 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp | |
| Buildings | BuildingsGrp |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $38,649 | OtherCostOrOtherBasisAmt |
| Depreciation | $38,649 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Equipment | EquipmentGrp | |
| Other Land Buildings | OtherLandBuildingsGrp | |
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED RENT | $51,883 |
| SECURITY DEPOSIT PAYABLE | $14,677 |
| DEFERRED EXECUTIVE TRUST FUNDS | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $66,560 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $72,259,076 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$13,959 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $772,123 | OtherRevenueAmt |
| Revenue Not Reported | $758,164 | RevenueNotReportedAmt |
| Revenue Subtotal | $71,500,912 | RevenueSubtotalAmt |
| Other Revenues Not Included | $1,211,474 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $1,211,474 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $72,712,386 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $67,145,162 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | -$10,677 | OtherExpensesIncludedAmt |
| Expenses Not Reported | -$10,677 | ExpensesNotReportedAmt |
| Expenses Subtotal | $67,155,839 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $713,667 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $713,667 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $67,869,506 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - SCHEDULE D - 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, 2015 and 2014, there were no liabilities recorded for uncertain tax positions. |
| FORM 990 - SCHEDULE D - RECONCILIATION OF REVENUE - PART XI | The organization's separate financial statements were prepared on a statutory basis in conformity with the manual and accounting practices prescribed and permitted by the DOI (NAIC SAP). The following adjustments were required: Line 2d - Additional revenue recognized on the financial statements $772,123; $510,918 statutory audit adjustment for reversal of prior year risk adjustment; $173,908 represents a reclassification for Allowance for Doubtful Accounts which was classified as revenue on the financial statements and an balance sheet account on Form 990; <$4,449> adjustment for bonds difference in market value vs amortized cost and $91,746 represents a reclassification of rental expense to revenue. Line 4b - Additional revenue recognized on the form 990 of $1,211,474 which is Premium Deficiency Reserve (PDR) Revenue classified as revenue on the form 990 and as an expense on the financial statements, the adjustment nets to zero with the adjustment in Part XII line 4b. |
| FORM 990 - SCHEDULE D - RECONCILIATION OF EXPENSES - PART XII | The organization's separate financial statements were prepared on a statutory basis in conformity with the manual and accounting practices prescribed and permitted by the DOI (NAIC SAP). The following adjustments were required: Line 2d - Additional expenses recognized on form 990 of $10,677 represents a reclassification of expenses which were classified as revenue on the financial statements. Line 4b - Additional expenses on the financial statements of $713,667; $1,211,474 of Premium Deficiency Reserve (PDR) Revenue classified as an expense on the financial statement and as revenue on form 990, the adjustment nets to zero with the adjustment in Part XI line 4b; <$406,061> represents statutory audit adjustment to reverse a prior year adjustment relating to the IBNR over reserve and <$91,746> of rental expense re-classed to revenue. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHRISTOPHER WING | ||||||||||||||
| DIRECTOR/CHAIRMAN | $0 | $613,351 | $0 | $426,532 | $0 | $21,473 | $0 | $1,162,962 | $0 | $18,058 | $0 | $2,242,376 | $0 | $426,532 |
| CATHERINE BATTEER | ||||||||||||||
| DIRECTOR/PRESIDENT | $0 | $333,662 | $0 | $112,707 | $0 | $21,076 | $0 | $348,069 | $0 | $1,801 | $0 | $817,315 | $0 | $112,707 |
| WILLIAM ROTH | ||||||||||||||
| DIRECTOR | $0 | $440,100 | $0 | $196,239 | $0 | $21,473 | $0 | $580,675 | $0 | $34,280 | $0 | $1,272,767 | $0 | $196,239 |
| VINOD MOHAN | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $0 | $411,018 | $0 | $129,752 | $0 | $19,212 | $0 | $427,998 | $0 | $30,687 | $0 | $1,018,667 | $0 | $29,752 |
| JANET KORNBLATT | ||||||||||||||
| SECRETARY | $0 | $317,993 | $0 | $62,536 | $0 | $27,449 | $0 | $352,195 | $0 | $12,900 | $0 | $773,073 | $0 | $62,536 |
| WENDY KARSTEN | ||||||||||||||
| OUTGOING VP GENERAL MANAGER | $40,640 | $0 | $22,243 | $0 | $117,452 | $0 | $0 | $0 | $1,986 | $0 | $182,321 | $0 | $0 | $0 |
| RICHARD PEITZMEIER | ||||||||||||||
| VICE PRESIDENT - SALES | $190,994 | $0 | $32,251 | $0 | $21,472 | $0 | $106,807 | $0 | $3,210 | $0 | $354,734 | $0 | $0 | $0 |
| KAREN SUGANO | ||||||||||||||
| CORPORATE VP GENERAL MANAGER | $0 | $273,839 | $0 | $75,288 | $0 | $18,074 | $0 | $59,801 | $0 | $6,827 | $0 | $433,829 | $0 | $0 |
| ANDREW WHITELOCK | ||||||||||||||
| CHIEF RISK EXECUTIVE | $0 | $215,248 | $0 | $33,277 | $0 | $18,497 | $0 | $18,090 | $0 | $4,032 | $0 | $289,144 | $0 | $0 |
| RUSSELL BROWER | ||||||||||||||
| CHIEF MEDICAL DIRECTOR | $0 | $280,017 | $0 | $80,430 | $0 | $20,667 | $0 | $106,936 | $0 | $30,084 | $0 | $518,134 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - SCHEDULE J - PART I, LINE 1A | The Star Rating System was established by the Centers for Medicare and Medicaid Services (CMS) as part of an effort to help educate consumers on quality and make quality data more transparent and comparable between plans. Under the system CMS ranks health plans on a one- to five-star basis, weighing such factors as clinical outcomes, access to preventive services such as screenings and vaccines, managing chronic conditions, preventive care, and consumer satisfaction. Star ratings are calculated each year and may change from one year to the next. In 2015, SCAN Health Plan earned a 4.5 star rating from CMS; in acknowledgement of this achievement, all SCAN employees below senior vice president were awarded a net after tax Star bonus of $450.00 (the amount was grossed up for applicable taxes). |
| FORM 990 - SCHEDULE J - PART I, LINE 3 | Compensation for the President was established and paid by a related organization. The related organization used the following to establish the Presidents compensation: 1) Compensation Committee; 2) Independent Compensation Consultant; (3) Compensation Survey or Study |
| FORM 990 - SCHEDULE J - PART I, LINE 4A-C | During 2015 the employment relationship of the following employee of SCAN Health Plan Arizona ended. In connection with the termination of her employment, SCAN Health Plan Arizona negotiated and paid severance to the employee. The severance payment was in accordance with the terms of the key employees then existing employment agreement. Wendy J Karsten, Outgoing VP General Sales - SCAN Health Plan Arizona, $111,212. |
| FORM 990 - SCHEDULE J - PART I, LINE 4B | The Company provides a supplemental non-qualified retirement plan to only officers and senior vice presidents via its section 457(f) plan. The following individuals participated in the companys section 457(f) plan during the year 2015: Christopher Wing, Catherine Batteer, William H. Roth, Janet Kornblatt and Vinod Mohan. Pursuant to the terms and conditions of the Section 457(f) Plan, a participant becomes 100% vested in the employer contribution upon the occurrence of any of the following while the participant is an employee. 1) The participant has ten years of continuous employment, counting only service after December 31, 2005. 2) The participant reaches the age of 62 and has five years of continuous employment; 3) The participants involuntary termination; 4) The participants disability; or 5) The participants death. DEFERRED COMPENSATION FOR 2015, REPORTED ON SCHEDULE J, PART II, AND COLUMN C CONSISTS OF THE FOLLOWING: 1) 457(F) EMPLOYER CONTRIBUTIONS SUBJECT TO VESTING TERMS AND CONDITIONS AS NOTED IN ITEMS (1) THROUGH (5) ABOVE. 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 CONTRIBUTES TO UP TO THE COMPANY'S DEFINED AND IRS ANNUAL LIMITS. 3) 403(B) QUALIFIED RETIREMENT PLAN CONTRIBUTIONS (EMPLOYER MATCH AND SAFE HARBOR) UP TO THE IRS ANNUAL LIMITS. 4) THE COMPANY PROVIDES AN INCENTIVE PLAN TO DIRECTORS AND ABOVE. THERE ARE TWO COMPONENTS OF THE COMPANY INCENTIVE PLAN (ICP): A. ANNUAL ICP AWARD - PAID ON OR AROUND APRIL 1ST OF THE SUBSEQUENT YEAR. B. DEFERRED ICP AWARD - BASED ON THE VESTING TERMS AND CONDITIONS FOR THIS COMPONENT, THERE IS SUBSTANTIAL RISK OF FORFEITURE. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - PROGRAM SERVICE ACCOMPLISHMENTS - PART III, LINE 3 | SCAN Health Plan Arizona elected to cease operations in Arizona- effective January 1, 2016. SCAN'S decision to exit the Arizona market followed years of financial losses, uncertainty about future revenue, and uncertainty about future sustainability and the ability to serve our members. |
| FORM 990 - PROGRAM SERVICE ACCOMPLISHMENTS - PART III, LINE 4A | SCAN Health Plan Arizona began program operations as a Medicare Advantage contractor effective January 1, 2007. It is responsible for arranging and monitoring the full range of Medicare health services for plan enrollees. The plan began offering a Medicare advantage special needs plan (SNP) for beneficiaries who were dually eligible and enrolled in both the Medicare and ALTCS programs. Beginning January 1, 2009, the Plan expanded its Medicare advantage participation to other Medicare beneficiary populations, through a Medicare advantage prescription drug (MAPD) plan. In January 2008 SCAN launched the SCAN Connections community resource center designed to link SCAN members, their caregivers and others in the Maricopa county communities with knowledgeable staff who could assist in navigating a complex health care system. The resource center staff built bridges into other community organizations, governmental agencies and health advocacy groups to provide to the community health education and support services focused on geriatric, chronic illness and physically disabled challenges. Services and resources were provided at the SCAN Connections resource center in SCANs office. SCAN Health Plan Arizona elected to cease operations in Arizona- effective January 1, 2016. |
| FORM 990 - GOVERNANCE, MGMT & DISCLOSURE-PART VI SECTION A LINE 6 | The Sole Member of the organization is SCAN Group, A California Nonprofit Public Benefit Corporation. |
| FORM 990 -GOVERNANCE, MGMT & DISCLOSURE-PART VI SECTION A LINE 7A | The sole member has the power to appoint the members of the Board of Directors. |
| FORM 990 - POLICIES - PART VI, SECTION B, LINE 11B | The Form 990 is prepared by BDO USA, LLP working in conjunction with SCANs finance department. SCAN Health Plans 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 and/or knowledge regarding the various matters disclosed and/or described in the Form. The General Counsel, in particular, reviews the Form 990 and ensures accuracy of descriptions and that disclosure is complete. The draft Form 990 is reviewed by the Audit and Compliance Committee of the Board of Directors of SCAN Group, and is shared with all members of the Board of Directors after it is prepared, but prior to filing. |
| FORM 990 - POLICIES - PART VI, SECTION B, LINE 12C | SCAN Health Plan Arizona regularly and consistently monitored and enforced compliance with its Conflict of Interest policy through annual circulation of a Conflict of Interest questionnaire which all members of the Board of Directors, officers and members of executive management must complete and sign. In addition, there is annual mandatory compliance education and training. SCANs Compliance Department is responsible for enforcement of SCANs robust compliance program and SCANs Policies and Procedures. Members of the Executive Team also have responsibility for enforcement. The legal department of SCAN Group reviews all contractual relationships entered into by the organization and the SCANs General Counsel is responsible for monitoring the Conflict of Interest questionnaire. The legal department of SCAN Group monitors and enforces adherence to these policies on an ongoing basis. |
| FORM 990 - POLICIES - PART VI, SECTION B, LINE 15A | The process for determining the compensation of the President of SCAN Health Plan Arizona is conducted by the Compensation Committee of the Board of Directors of SCAN Group, all of the voting members of which are independent persons. In determining the Presidents compensation, the Compensation Committee work with and rely upon the counsel and expertise of Ernst & Young, a consultant with well-established experience and expertise in the area of nonprofit organization executive compensation and compliance with the intermediate sanctions requirements applicable to such compensation. Ernst & Young provides an "Executive Compensation Report" to the Compensation Committee each year which furnishes the basis for the establishment of the Presidents compensation package during the following year. The Ernst & Young Executive Compensation Report is based on a review of the executive compensation practices of a variety of organizations that are considered comparable to SCAN Health Plan Arizona based on various metrics. The Compensation Committee deliberates on the issue of the Presidents compensation package in light of the Ernst & Young Executive Compensation Report and questions are asked of, and answered by, Ernst & Young, regarding such report and other matters relevant to such package. Pursuant to their deliberations, the Compensation Committee makes a recommendation to the Board of Directors of SCAN Health Plan Arizona regarding the compensation package for the following year. |
| FORM 990 - POLICIES - PART VI, SECTION B, LINE 15B | The process for determining the compensation of officers and key employees of SCAN Health Plan Arizona is conducted by the Human Resources Department and President. In determining such employee's compensation, the Human Resources Department and Compensation Committee work with and rely upon the counsel and expertise of Ernst & Young, a consultant with well-established experience and expertise in the area of nonprofit organization executive compensation and compliance with the intermediate sanctions requirements applicable to such compensation. Ernst & Young provides an "Executive Compensation Report" to the Human Resources Department each year which furnishes the basis for the establishment of such employees' compensation package during the following year. The Ernst & Young Executive Compensation Report is based on a review of the executive compensation practices of a variety of organizations that are considered comparable to SCAN Group based on various metrics. The President makes a recommendation to the Compensation Committee with respect to each employees compensation package in light of the Ernst & Young Executive Compensation Report. At the Compensation Committee meeting addressing such matters, questions are asked of, and answered by Ernst & Young, regarding such report and other matters relevant to the package. Based on such 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 deliberations and decisions. |
| FORM 990 - DISCLOSURE - PART VI, SECTION C, LINE 19 | SCAN Health Plan Arizona's governing documents and conflict of interest policy are not made available to the public. SCAN Health Plan Arizona's audited financial statements are publicly available from the Arizona Department of Insurance for a nominal fee. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:BROKER COMMISSIONS TOTAL FEES:1504115 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PHARMACY ADMIN EXPENSE TOTAL FEES:323425 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONSULTANTS & OUTSIDE SERVICES TOTAL FEES:98382 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:MEDICAL EXPENSES FOR ELDERLY TOTAL FEES:62332722 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| SCAN GROUP | ||||||||||
| 3800 KILROY AIRPORT SUITE 100 | LONG BEACH | CA | 90806 | 953826037 | ADMIN SUPPORT | CA | 501(C)(3) | 11b | NA | false |
| SCAN HEALTH PLAN | ||||||||||
| 3800 KILROY AIRPORT SUITE 100 | LONG BEACH | CA | 90806 | 953858259 | MEDICARE ADVA | CA | 501(C)(3) | 9 | SCAN GROUP | Yes (true) |
| THE SCAN FOUNDATION | ||||||||||
| 3800 KILROY AIRPORT SUITE 400 | LONG BEACH | CA | 90806 | 450552845 | GRANT MAKING | CA | 501(C)(3) | 11b | SCAN GROUP | Yes (true) |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| SCAN HEALTH CHECK ASSESSMENT CENTERS | |||||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 462962358 | HEALTHCARE | CA | NA | C COPRORATION | $0 | $0 | false |
| SCAN CALIFORNIA MANAGEMENT COMPANY | |||||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 462951831 | MANAGEMENT | CA | SCAN GROUP | C CORPORATION | $0 | $0 | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| SCAN Health Plan | ||
| P | $1,222,686 | SG&A, SCAN HP |
| SCAN Group | ||
| P | $1,042,170 | SG&A,SCAN GROUP |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990 - TRANSACTIONS WITH RELATED ORGANIZATIONS - SCHEDULE R, PART V | FormAndLineReferenceDesc |
| Explanation | The percentage of allocation to affiliated companies is determined based on estimated percentage of time worked, percentage of SCAN membership, and the percentage of bid submissions, as appropriate based on the nature of the expense. | ExplanationTxt |