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      <Description>member health care services and medical training for care improvement Kaiser Foundation Health Plan of Ohio (KFHP of Ohio) provides medical and surgical care, including urgent care services, extended care and home health care, for its members without regards to age, sex, race, religion or national origin or the ability to pay. KFHP of Ohio educates and trains medical students and other health care professionals and promotes scientific and nursing education in order to improve care. Additional information about Ohio Health Plan's charitable activities can be found in Schedule O, Community Benefit Summary Report.</Description>
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        <Description>Grants and Donations The Ohio Health Plan supported approximately 60 nonprofit organizations and government agencies through the distribution of charitable contributions in 2012. Donations were strategically targeted to address the objectives of our four priority areas or streams of work. These funds enabled the nonprofit organizations and government agencies with whom we partner to continue providing programs and services that benefit vulnerable populations within the communities served by KFHP. Additional information about Ohio Health Plan's charitable activities can be found in Schedule O, Community Benefit Summary Report.</Description>
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        <Identifier>Schedule C, Part II-B, Line 1A - 1I</Identifier>
        <Explanation>LOBBYING ACTIVITY BY NONELECTING PUBLIC CHARITIES The Organization is a member of the Kaiser Permanente Medical Care Program and participated in and benefited from lobbying activities conducted at the regional and national levels for the benefit of its enrolled members and for the health care industry as a whole. As an organization exempt from income tax under Internal Revenue Code Section 501(c)(3), Health Plan has a policy prohibiting internal involvement in any political campaigns. This policy is closely monitored for compliance. During the year this Organization may have made comments or statements concerning legislation which may affect the health care industry. Health Plan may have engaged in conversations with and/or written communications to various Federal, state, and local officials regarding matters which affected the healthcare industry as a whole. The amount of time and money involved in the activities is detailed on lines a through i. Health Plan employs individuals, including one or more registered lobbyists and/or may retain one or more professional consultants to represent Health Plan's interests in various legislative and regulatory bodies and from time-to-time to keep informed about Federal and state legislation having an impact on Health Plan's charitable activities as an exempt Health Maintenance Organization. These individuals attempt to ensure that proposed legislation and enacted laws are compatible with the interests of Health Plan and its members by performing the following activities: (I) Collecting, analyzing and distributing within the Organization, public and private policy recommendations regarding proposed legislation that affect the operation of Health Plan and its ability to provide quality health and medical care services to its members in a cost effective environment. (II) Providing appropriate informational materials to legislators and to their staffs that pertain to matters of common interest in the health care community and in the not-for-profit community. (III) Also by preparing written and oral testimony, these individuals appear at legislative hearings, monitor legislative proceedings and meet with legislators and/or their staffs regarding issues pertinent to the mission of Health Plan. Those individuals appearing at such hearings and meetings for and on behalf of Health Plan often are representing the interests of common interest groups as well as the interests of the members of Health Plan. (IV) Other employees and officers perform services by delivering speeches at various public and private functions and in serving as faculty in healthcare related educational programs throughout the community.</Explanation>
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      <Form990ScheduleCPartIV>
        <Identifier>Schedule C, Part I-B, Line 3 &amp; 4</Identifier>
        <Explanation>In March 2013, we became aware of payments to two organizations which self-identified as Political Action Committees (PACs). Due to the timing, we chose to take a conservative stance and extend and pay the political expenditure related fines and taxes while we researched the two transactions. The documentation provided by the PAC's showed we did not have a taxable event. We filed Forms 4720 and 1120-POL to request full refunds only.</Explanation>
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        <PurposeOfGrant>Race for Kids &amp; Well</PurposeOfGrant>
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          <City>Cleveland</City>
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        <PurposeOfGrant>HEAL Evaluation</PurposeOfGrant>
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          <City>Cleveland</City>
          <State>OH</State>
          <ZIPCode>44114</ZIPCode>
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        <PurposeOfGrant>Army of Believers</PurposeOfGrant>
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          <ZIPCode>44110</ZIPCode>
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        <PurposeOfGrant>Sing Out!, Event</PurposeOfGrant>
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          <BusinessNameLine1>Cleveland State University Foundation Inc</BusinessNameLine1>
        </RecipientNameBusiness>
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          <AddressLine1>2121 Euclid Ave MM105</AddressLine1>
          <AddressLine2>Univ Circle</AddressLine2>
          <City>Cleveland</City>
          <State>OH</State>
          <ZIPCode>44115</ZIPCode>
        </AddressUS>
        <EINOfRecipient>341316665</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
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        <PurposeOfGrant>Careers Health/Med/Wellness</PurposeOfGrant>
      </RecipientTable>
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          <BusinessNameLine1>Cuyahoga Community College Foundation</BusinessNameLine1>
        </RecipientNameBusiness>
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          <AddressLine1>700 Carnegie Ave</AddressLine1>
          <City>Cleveland</City>
          <State>OH</State>
          <ZIPCode>44115</ZIPCode>
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        <EINOfRecipient>237320719</EINOfRecipient>
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        <AmountOfCashGrant>22700</AmountOfCashGrant>
        <PurposeOfGrant>Bridgeport Food Des;Presidential Scholarship Lunch</PurposeOfGrant>
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        </RecipientNameBusiness>
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          <AddressLine1>75 Erieview Plaza</AddressLine1>
          <City>Cleveland</City>
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          <ZIPCode>44114</ZIPCode>
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        <EINOfRecipient>271217221</EINOfRecipient>
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        <PurposeOfGrant>Support Cuyahoga</PurposeOfGrant>
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          <State>OH</State>
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        <PurposeOfGrant>Operating Support</PurposeOfGrant>
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        <PurposeOfGrant>Care and Prevention</PurposeOfGrant>
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          <BusinessNameLine1>Legal Aid Society of Cleveland</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>1223 West Sixth St</AddressLine1>
          <City>Cleveland</City>
          <State>OH</State>
          <ZIPCode>44113</ZIPCode>
        </AddressUS>
        <EINOfRecipient>340866026</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
        <AmountOfCashGrant>25000</AmountOfCashGrant>
        <PurposeOfGrant>Community Advocacy</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Near West Side Multi Service Corporation</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>4115 Bridge Ave</AddressLine1>
          <City>Cleveland</City>
          <State>OH</State>
          <ZIPCode>44113</ZIPCode>
        </AddressUS>
        <EINOfRecipient>237061949</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
        <AmountOfCashGrant>25000</AmountOfCashGrant>
        <PurposeOfGrant>May Dugan Cnter Hlth</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>North Coast Health Ministry</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>16110 Detroit Ave</AddressLine1>
          <City>Lakewood</City>
          <State>OH</State>
          <ZIPCode>44107</ZIPCode>
        </AddressUS>
        <EINOfRecipient>341536257</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
        <AmountOfCashGrant>40380</AmountOfCashGrant>
        <PurposeOfGrant>Operating Support</PurposeOfGrant>
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      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Northeast Ohio Neighborhood</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>4800 Payna Ave</AddressLine1>
          <City>Cleveland</City>
          <State>OH</State>
          <ZIPCode>44103</ZIPCode>
        </AddressUS>
        <EINOfRecipient>341014291</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
        <AmountOfCashGrant>6798</AmountOfCashGrant>
        <PurposeOfGrant>Golf Outing Spons'p</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>St Martin De Porres High School Work Study</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>6111 Lausche Ave</AddressLine1>
          <City>Cleveland</City>
          <State>OH</State>
          <ZIPCode>44103</ZIPCode>
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        <EINOfRecipient>300204919</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
        <AmountOfCashGrant>16384</AmountOfCashGrant>
        <PurposeOfGrant>Corporate Work Study</PurposeOfGrant>
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      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>The Living Miracles Peer Empowerment Center</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>11801 Clifton Blvd 2</AddressLine1>
          <City>Lakewood</City>
          <State>OH</State>
          <ZIPCode>44107</ZIPCode>
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        <EINOfRecipient>611601980</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
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        <PurposeOfGrant>Wellness Management</PurposeOfGrant>
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      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>United Negro College Fund - Dec 12 Accrual</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>2000 Auburn Drsite 200</AddressLine1>
          <City>Cleveland</City>
          <State>OH</State>
          <ZIPCode>44122</ZIPCode>
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        <PurposeOfGrant>CB Contribution</PurposeOfGrant>
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      <RecipientTable>
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          <BusinessNameLine1>United States Conference Catholic Bishops</BusinessNameLine1>
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          <AddressLine1>1228 Euclid Ave 330</AddressLine1>
          <City>Cleveland</City>
          <State>OH</State>
          <ZIPCode>44115</ZIPCode>
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        <PurposeOfGrant>OH Reg Convergence</PurposeOfGrant>
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          <BusinessNameLine1>United Way of Greater Cleveland</BusinessNameLine1>
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          <AddressLine1>1331 Euclid Ave</AddressLine1>
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        <AmountOfCashGrant>25851</AmountOfCashGrant>
        <PurposeOfGrant>KP Communi Care Fund</PurposeOfGrant>
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      <RecipientTable>
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          <BusinessNameLine1>YMCA of Cleveland Ohio Inc</BusinessNameLine1>
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          <AddressLine1>2200 Prospect Ave 900</AddressLine1>
          <City>Cleveland</City>
          <State>OH</State>
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        <PurposeOfGrant>We RunThisCity Youth</PurposeOfGrant>
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      <Form990ScheduleIPartIV>
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        <Explanation>Grantees are required to sign a memorandum of understanding prior to grant funds disbursal. Grantees are required to submit a final report which delineates accomplishments, related to stated objectives, and describe the evaluation method used to assess accomplishments.</Explanation>
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    </IRS990ScheduleI>
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        <Title>VP, Off of Brd &amp; Corp Gov Svcs</Title>
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        <NamePerson>Mark Zemelman</NamePerson>
        <Title>SVP, Gen Counsel &amp; Secretary</Title>
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      <Form990ScheduleJPartIII>
        <Identifier>Schedule J, part II</Identifier>
        <Explanation>J. Neal Purcell - Board of directors to 12/31/2012. Bernard Tyson - Board of directors effective 12/06/2012. Steven Zatkin - General Counsel to 6/30/2010; Consultant 3/4/2011 to present. Schedule J, part I, Line 3 Kaiser foundation health plan of ohio relied on kaiser foundation health plan, inc. that used one or more of the methods described below to establish the top management officials' compensation: - Compensation committee - Independent compensation consultant - Form 990 of other organizations - Written employment contract - Compensation survey or study, and - Approval by the board or compensation committee.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>Schedule J, Part I, Line 4a</Identifier>
        <ReturnReference>SEVERANCE PAYMENTS</ReturnReference>
        <Explanation>Joseph LaGuardia $ 24,615 Thomas Revis 232,870 Listed persons participated in arrangements entitling them to severance benefits in the event of termination by the organization without cause or due to job elimination. Depending on position level, tenure, and termination reason, severance benefits payable under these arrangements provide for pay and health benefits continuation plus payment of accrued obligations. In addition, for some of the listed persons, severance benefits payable include prorated incentive awards for performance periods not yet ended. None of the listed persons participated in arrangements entitling them to change-of-control payments.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>Schedule J, Part I, Line 4b</Identifier>
        <ReturnReference>SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS</ReturnReference>
        <Explanation>GEORGE HALVORSON $ 1,500,000 KATHRYN LANCASTER 790,314 THOMAS MEIER 1,075 ARTHUR SOUTHAM 1,021,889 DEBORAH STOKES 43,578 BERNARD TYSON 1,036,741 STEVEN ZATKIN 16,632 VICTORIA ZATKIN 3,175 MARK ZEMELMAN 126,344 TIMOTHY ALBERTS 26 Some of the listed persons participated in nonqualified supplemental retirement plans. Under these plans, the organization makes annual contributions to accounts held in the name of individual participants. Contributions vary by position level and pay, and vest over time based on age and/or service. Participant accounts are credited with actual investment returns from up to four mutual funds and/or with a fixed rate of interest or a combination thereof. Unvested amounts are subject to risk of forfeiture.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>Schedule J, Part I, Line 7</Identifier>
        <ReturnReference>NON-FIXED PAYMENTS</ReturnReference>
        <Explanation>The organization provided non-fixed payments to some of the persons listed. Payments were made under incentive plans, based on attainment of organizational performance goals and individual performance, designed to support the organization's mission to provide high-quality, affordable care and improve the health of its members and the communities it serves.</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <GeneralExplanation>
        <Identifier>Form 990, Heading, Item B, Amended Return</Identifier>
        <Explanation>Part VII and Schedule J of the return have been amended to reflect updated compensation information regarding certain deferred compensation calculations. Form 990, Part VI, Line 4 Changes to governing documents The Articles of Incorporation of the Corporation were amended in 2012 as described in paragraphs 1 and 2 below: 1. Articles Four and Seven of the Articles of Incorporation of the Corporation were amended to: (a) set forth a broad statement of the corporation's primary purposes that reflects current case law; (b) revise the nondiscrimination language to be consistent with current legal standards; and (c) expressly state that the corporation is prohibited from engaging in activities not permitted by Section 501(c)(3) of the Internal Revenue Code and to specifically state that the corporation shall not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. A Certificate of Amendment by Member was filed February 7, 2012; and 2. Article Six was amended to replace the term "Code of Regulations" with "Bylaws" and the articles were fully restated to correctly set forth in one document all of the provisions of the articles currently on file. Amended and Restated Articles of the Corporation were filed August 30, 2012. The Bylaws of the Corporation were amended in 2012 as follows: On December 6, 2012, Article D, Directors and Article E, Officers were amended to provide for up to fifteen directors and up to three inside directors, and the possibility of the Chairman of the Board and the Chief Executive Officer not being the same person.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 6</Identifier>
        <Explanation>KAISER FOUNDATION HEALTH PLAN, INC. IS the SOLE MEMBER. Upon dissolution, remaining assets shall be distributed to a 501(c)(3) organization.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 7a</Identifier>
        <Explanation>Kaiser Foundation Health Plan, Inc. (KFHP) appoints the Directors (and fills vacancies and has authority to remove Directors). The same 15 individuals who comprise the Board of Directors of KFHP also serve as the 15 Directors of KFHP Colorado, Ohio, Northwest and Mid-Atlantic States.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 7b</Identifier>
        <Explanation>The following actions of the corporation require approval of the sole member: a. removal of the Chairman of the Board or any President; b. amendment of Article D, Section D-4 of the Bylaws - Election and Term of Office of Directors.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 11b</Identifier>
        <ReturnReference>Form 990 review process</ReturnReference>
        <Explanation>1. Key information necessary for the preparation of the tax return is obtained and/or confirmed with internal sources including regional finance, executive compensation, community benefits, treasury, government relations, and legal. 2. Community benefits details are presented to the community benefit committee of the board for review. 3. Executive compensation details are presented to the compensation committee of the board for review. 4. The complete tax return is reviewed and signed by a Pricewaterhousecoopers LLP tax advisor. 5. The complete tax return is reviewed and signed by an officer or a member of management designated by an officer. 6. A copy of the return is provided to each board member prior to filing.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 12c</Identifier>
        <ReturnReference>COMPLIANCE ENFORCEMENT</ReturnReference>
        <Explanation>A. Regularly and Consistently Monitors Compliance with the Conflicts of Interest Policy - Kaiser Permanente regularly monitors compliance with the Conflicts of Interest Policy in 3 key ways: 1. The Kaiser Permanente Compliance Hotline is available to all employees and vendors to report actual or potential conflicts of interest. All calls are answered by a third party and provided to Kaiser Permanente's National Compliance Office for review and appropriate action. Employees can report anonymously. Retaliation is prohibited. Reports of actual or potential Conflicts of Interest are generated and investigations are conducted as required and information is tracked and trended to determine if additional guidance is required to avoid or manage conflicts of interest. Compliance Hotline Reports are provided for review and action to the Kaiser Foundation Health Plan/Hospitals Boards of Directors annually. 2. The National Compliance Office and Internal Audit Services annually review the directors', officers', key employees', and executives' Annual Conflicts of Interest Questionnaire disclosures and provide direction on any investigations required. Investigations are documented, tracked and trended to determine if additional controls or education is required. In addition, Conflicts of Interest Questionnaire reports are provided for review and action to the Kaiser Foundation Health Plan/Hospitals Boards of Directors annually; and 3. Annually, as a component of the external audit, KPMG reviews the Annual Conflicts of Interest Questionnaires process completed by Directors, Officers, Key Employees, and Executives, and actions taken as a result of the disclosures. The results of the annual audit, including any findings in this area are presented to the Kaiser Foundation Health Plan/Hospitals Audit and Compliance Committee. B. Regularly and Consistently Enforces Compliance with the Conflicts of Interest Policy - To ensure consistency in the enforcement of the policy Kaiser Permanente uses the following steps as a general guideline: 1. Represented employees are subject to any corrective/disciplinary action provisions described in specific regional/national collective bargaining agreements and/or organizational policies and practices. 2. Kaiser Permanente informs employees of the National Human Resources Policy No. 14. Corrective/Disciplinary Action Policy during new employee orientation and in annual compliance training. 3. In the event that it is necessary to discipline any employee because of, but not limited to, failure to comply with applicable legal/regulatory requirements, Kaiser Permanente policies and procedures, or the Principles of Responsibility, or for unsatisfactory performance or misconduct, coaching/counseling and/or corrective/disciplinary action may include, but is not limited to: - Oral discussion and/or warning by the employee's immediate supervisor or higher level manager to correct the problem; - Written notice, with or without final warning; - Paid or unpaid suspension, with or without final warning; - Termination of employment.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 15a/b</Identifier>
        <ReturnReference>COMPENSATION DETERMINATION</ReturnReference>
        <Explanation>The executive compensation program is designed to recruit, retain and motivate qualified senior management personnel. Senior management personnel have a significant impact on the strategic and policy direction and results of the organization. Therefore, the executive compensation program is, to a significant degree, performance-based. The compensation program is reviewed annually by the Compensation Committee of the Board of Directors which evaluates and approves, prior to payment, all programs and payments to CEO, Executive Director and top management officials (executives). Base pay for executive positions is established at a level comparable to the relevant market. In addition, other components of the compensation program bear 'at-risk' features designed to focus on strategically important performance goals and to assist in attracting and retaining top performers. The executive compensation program is targeted at the median of the comparable external market in which the organization competes for executive leadership. Evaluation of comparable pay data is performed by an Independent Compensation, Benefit &amp; Human Resource Consulting firm. The compensation program focuses on objectives in the areas of quality of member care and service, financial soundness, and the community and social mission of the organization.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 18</Identifier>
        <Explanation>available on www.guidestar.org.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 19</Identifier>
        <ReturnReference>PUBLIC INSPECTION</ReturnReference>
        <Explanation>Governing documents - are available from the Department of Insurance and maintained on the state agency website or upon request. Conflict of Interest is available on KP website under vendor Principles of Responsibility or upon request. Financial Statements are on file with state insurance agency on a statutory basis (stand alone entity). Combined data is published for Kaiser Foundation Health Plan Inc. and subsidiaries and Kaiser Foundation Hospitals and Subsidiaries with audit opinion by KPMG and is available upon request. To request copies contact: Vice President - National Tax Compliance Kaiser Foundation Health Plan and Hospitals One Kaiser Plaza, Suite 15L Oakland, CA 94612</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VII, Section A, Column B</Identifier>
        <ReturnReference>HOURS FOR RELATED ORGANIZATION</ReturnReference>
        <Explanation>Hours for Related Organizations Individuals who are both officers and members of Boards of Directors work full time as employees as well as fulfill their board assignment. All officers work full time in their employee capacity. Full time work may require in excess of the traditional 40 hour week. Given the integrated nature of our organization, employees may provide support for various Kaiser Permanente companies. The average hours per week reported for the filing organization and related organizations was estimated.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part XI, Line 9</Identifier>
        <ReturnReference>Other changes in net assets or fund balances</ReturnReference>
        <Explanation>Change in Other Comprehensive Income 8,143,247 Gain/Loss on investments - Tax &lt; 1,003,012 &gt; Gain/Loss on Investments - Book 1,205,220 Other Than Temporary Impairments &lt; 121,194 &gt; ________________ TOTAL $ 8,224,261</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part III, Line 4a - 4d</Identifier>
        <ReturnReference>Exempt Purpose Achievements - Program Services</ReturnReference>
        <Explanation>2012 COMMUNITY BENEFIT SUMMARY REPORT KAISER FOUNDATION HEALTH PLAN OF OHIO KAISER FOUNDATION HEALTH PLAN'S COMMITMENT TO THE COMMUNITY IN 2007, KAISER FOUNDATION HEALTH PLAN'S BOARD OF DIRECTORS REFINED THE FOCUS OF THE ORGANIZATION'S COMMUNITY BENEFIT PROGRAM AND ESTABLISHED THE FOLLOWING FOUR PRIORITY AREAS WHICH HAVE COME TO BE KNOWN AS "STREAMS OF WORK": A. CARE AND COVERAGE FOR LOW-INCOME PEOPLE - CREATES AND SUPPORTS PROGRAMS THAT LOWER THE FINANCIAL BARRIERS FOR THE UNDER-AND UNINSURED. B. COMMUNITY HEALTH INITIATIVES (CHI) - SEEKS TO MEASURABLY IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. DESIGNS, DELIVERS, AND SUSTAINS LONG-TERM PROGRAMS THAT ENGAGE COMMUNITIES IN WORK TO IMPROVE CONDITIONS IN THEIR NEIGHBORHOODS. C. SAFETY NET PARTNERSHIPS - BUILDS PARTNERSHIPS WITH COMMUNITY CLINICS, LOCAL HEALTH DEPARTMENTS, AND PUBLIC HOSPITALS. PROVIDES FUNDING, TECHNICAL ASSISTANCE, DISSEMINATION OF CARE MANAGEMENT AND QUALITY IMPROVEMENTS TECHNOLOGY TO HELP IMPROVE CARE AND EXPAND TREATMENT CAPACITY FOR VULNERABLE POPULATIONS. D. DEVELOPING AND DISSEMINATING KNOWLEDGE - IMPROVES HEALTH CARE BY SHARING OUR KNOWLEDGE - EDUCATING PRACTITIONERS, ADVANCING RESEARCH, EMPOWERING CONSUMERS AND INFORMING POLICYMAKERS ABOUT THE EVIDENCE BASE FOR CARE AND HEALTH. THE FOLLOWING ARE DETAILS OF COMMUNITY BENEFIT ACTIVITIES PROVIDED BY KAISER FOUNDATION HEALTH PLAN OF OHIO: IN 2012, THE OHIO HEALTH PLAN SERVED 86,597 MEMBERS AND EXPENDED $13.2 MILLION (AT COST, NET OF $3.3 MILLION OF RELATED REVENUES) TO SUPPORT COMMUNITY BENEFIT ACTIVITIES. THE FOLLOWING SUMMARIZES MANY OF THE SIGNATURE COMMUNITY BENEFIT PROGRAMS AND SERVICES GROUPED ACCORDING TO THE FOUR STREAMS OF WORK.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>a. CARE AND COVERAGE FOR LOW-INCOME PEOPLE</Identifier>
        <Explanation>IN 2012, THE OHIO HEALTH PLAN EXPENDED $11.5 MILLION (AT COST, NET OF $3.3 MILLION OF RELATED REVENUES) TO ADDRESS THE FINANCING AND DELIVERY OF HEALTH CARE FOR POPULATIONS VULNERABLE DUE TO SOCIO-ECONOMIC STATUS, ILLNESS, ETHNICITY, AGE OR OTHER FACTORS. PROGRAM BENEFICIARIES (UNDER- AND UNINSURED) RECEIVED FREE OR DISCOUNTED CARE IN A KAISER PERMANENTE FACILITY OR BY A PERMANENTE PROVIDER. 1. CHARITABLE CARE (MEDICAL FINANCIAL ASSISTANCE AND CHARITABLE HEALTH COVERAGE PROGRAMS) IN OHIO, HEALTH PLAN PROVIDES CHARITY CARE TO LOW-INCOME VULNERABLE POPULATIONS THROUGH THE MEDICAL FINANCIAL ASSISTANCE AND CHARITABLE HEALTH COVERAGE PROGRAMS. IN 2012, THE OHIO HEALTH PLAN SPENT $9.8 MILLION (AT COST, NET OF $274 THOUSAND OF RELATED REVENUES) ON UNDER-AND UNINSURED PATIENTS. MEDICAL FINANCIAL ASSISTANCE OHIO HEALTH PLAN'S MEDICAL FINANCIAL ASSISTANCE (MFA) PROGRAM IS DESIGNED TO PROVIDE FINANCIAL RELIEF TO BOTH MEMBERS AND NON-MEMBERS WHO WOULD OTHERWISE BE UNABLE TO PAY FOR MEDICAL SERVICES. INCOME IS THE ONLY DETERMINANT, AND APPLICANTS WITH HOUSEHOLD INCOMES BELOW 250% OF THE FEDERAL POVERTY LEVEL QUALIFY. IF APPROVED, INDIVIDUALS RECEIVE ONE YEAR IN WHICH COST SHARING EXPENDITURES SUCH AS COPAYS ASSOCIATED WITH THEIR SERVICES AT KAISER PERMANENTE FACILITIES INCLUDING PHARMACY (FOR MEMBERS) ARE SUBSIDIZED BY THE OHIO HEALTH PLAN. PATIENT ACCOUNTS AND BILLING SERVICES PROCESSES ALL APPLICATIONS FOR THESE BENEFITS AND MANAGES THE DAY-TO-DAY OPERATIONS OF THE PROGRAM. IN 2012, MORE THAN 3,300 QUALIFIED APPLICANTS BENEFITED FROM THE PROGRAM. CHARITABLE HEALTH COVERAGE CHARITABLE HEALTH COVERAGE (CHC) IS A UNIQUE APPROACH TO CARING FOR LOW-INCOME UNINSURED PERSONS IN THE COMMUNITY. ELIGIBLE PARTICIPANTS RECEIVE A REGULAR KAISER PERMANENTE MEMBERSHIP CARD AND ACCESS TO THE FULL RANGE OF OUR SERVICES AND PROVIDERS - A MUCH BETTER ALTERNATIVE TO A BRIEF AND COSTLY EMERGENCY ROOM VISIT OR HOSPITALIZATION. THIS ALLOWS US TO INVEST IN THE LONGER TERM HEALTH OF PATIENTS AND THE COMMUNITY. SINCE INCEPTION IN THE EARLY 1980S, CHC PROGRAMS HAVE MADE A REAL DIFFERENCE IN THE LIVES OF PERSONS WHO MIGHT OTHERWISE HAVE NO OTHER SOURCE OF CARE. THE FOLLOWING ARE TWO EXAMPLES OF THE CHARITABLE HEALTH COVERAGE PROGRAMS OFFERED BY THE OHIO HEALTH PLAN. - THE TRANSITION PLAN IS A 2-YEAR HMO INSURANCE PRODUCT THAT PROVIDES COVERAGE FOR LOW-INCOME INDIVIDUALS (UP TO 250% OF THE FEDERAL POVERTY LEVEL) WHO ARE NOT ELIGIBLE FOR PUBLIC PROGRAMS SUCH AS MEDICAID OR MEDICARE. APPLICANTS ARE REFERRED TO KAISER PERMANENTE THROUGH A HOTLINE TELEPHONE NUMBER THAT CONNECTS THEM TO OUR COMMUNITY PARTNER WHO ASSISTS THEM THROUGH THE APPLICATION PROCESS. MORE THAN HALF OF THE MEMBERS ARE NEW TO KP. THE PLAN SUBSIDIZES CO-PAYS AND PREMIUMS, CHARGING $20 PER MONTH FOR INDIVIDUALS AND $40 PER MONTH FOR FAMILIES. COVERED MEMBERS RECEIVE COMPREHENSIVE BENEFITS INCLUDING PRESCRIPTION DRUG COVERAGE AND HOSPITALIZATION. - THE ACCESS TO CARE INITIATIVE IS A PROGRAM OF THE HEALTHY CONNECTIONS NETWORK, A NONPROFIT ORGANIZATION LOCATED IN SUMMIT COUNTY, OHIO THAT LINKS UNINSURED INDIVIDUALS TO CARE. THE NETWORK UTILIZES PROVIDERS THROUGHOUT SUMMIT COUNTY TO PROVIDE UNCOMPENSATED, CHARITY CARE TO QUALIFIED (NON-MEDICAID ELIGIBLE) PATIENTS. PHYSICIANS IN THE CHAPEL HILL AND FAIRLAWN KAISER PERMANENTE FACILITIES PARTICIPATE IN THIS PROGRAM. THE NETWORK SERVES AS THE INITIAL POINT OF ENTRY FOR THE PATIENT AND MAKES REFERRALS TO PARTNER PROVIDERS BASED UPON CAPACITY AND PATIENT REQUEST. SERVICES INCLUDE PRIMARY CARE VISITS AND SOME ANCILLARY (LAB AND IMAGING) SERVICES. ALL SPECIALTY CARE REFERRALS ARE MADE BACK TO HEALTHY CONNECTIONS NETWORK. 2. MEDICAID THE OHIO HEALTH PLAN HAS A LONG HISTORY OF PARTICIPATION IN PUBLICLY FINANCED HEALTH PROGRAMS. IN 2012, THE OHIO REGION PROVIDED MEDICAL COVERAGE AND SERVICES VALUED AT APPROXIMATELY $1.7 MILLION (AT COST, NET OF $3.0 MILLION OF RELATED REVENUES) FOR INDIVIDUALS PARTICIPATING IN THE FOLLOWING PROGRAMS: - CARE SOURCE MEDICAID PROGRAM - THE OHIO HEALTH PLAN CONTRACTS WITH CARESOURCE, THE LARGEST MCO IN THE STATE. OHIO PERMANENTE PHYSICIANS PROVIDE CARE FOR CARESOURCE PATIENTS AT HEALTH PLAN FACILITIES. IN 2012, ALL PHYSICIANS AND FACILITIES WERE CREDENTIALED AS REQUIRED BY STATE REGULATIONS TO SEE THESE MEDICAID PATIENTS. THE DIFFERENCE BETWEEN COST OF CARE AND REIMBURSEMENT FROM CARESOURCE IS REPORTED AS AN INVESTMENT IN COMMUNITY BENEFIT. - MEDICARE-MEDICAID - THIS PROGRAM HELPS DUAL-ELIGIBLE (MEDICARE AND MEDICAID) MEMBERS ACCESS THE COMPREHENSIVE CARE THEY NEED. IN OHIO, STATE POLICY DOES NOT ALLOW USE OF STATE DOLLARS TO PAY FOR MEDICARE MONTHLY PREMIUMS, EVEN FOR LOW-INCOME PERSONS. THE DIFFERENCE BETWEEN THE TOTAL COST OF CARE AND REVENUE RECEIVED UNDER THE MEDICARE AND MEDICAID PROGRAMS IS REPORTED AS EXPENSES OF COMMUNITY BENEFIT.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>B. COMMUNITY HEALTH INITIATIVES (CHI)</Identifier>
        <Explanation>AS AN INNOVATOR IN HEALTH, KAISER PERMANENTE DESIGNS, DELIVERS AND SUSTAINS LONG-TERM PROGRAMS THAT ENGAGE COMMUNITIES IN WORK TO IMPROVE THE CONDITIONS IN THEIR NEIGHBORHOODS, WORKPLACES AND SCHOOLS THAT CAN SUPPORT GOOD HEALTH, PARTICULARLY HEALTHY EATING, ACTIVE LIVING (HEAL). THE OHIO HEALTH PLAN SPENT APPROXIMATELY $152 THOUSAND ON COMMUNITY HEALTH INITIATIVES DURING 2012. THE FOLLOWING IS ONE EXAMPLE OF A CHARITABLE CONTRIBUTION AWARDED TO SUPPORT COMMUNITY HEALTH INITIATIVES IN THE STATE OF OHIO. - THE COMMUNITY HEALTH INITIATIVE IN CLEVELAND'S WARD 1 IS IN ITS 7TH YEAR. IN 2012 FOCUS REMAINED ON BUILDING SUSTAINABLE INFRASTRUCTURE AND CAPACITY FOR THE INSTITUTIONAL HOME OF HEAL, MAINTAINING 10 COMMUNITY GARDENS AND PARTICIPATING IN NUMEROUS INITIATIVES TO CHANGE THE ENVIRONMENT AND IMPACT POLICY TO MAKE HEALTHY EATING AND ACTIVE LIVING THE EASY CHOICE. HEAL ADVOCACY EFFORTS LED THE CITY OF CLEVELAND TO INCLUDE AND FUND THE CONSTRUCTION OF A WALKING PATH INTO THE CITY'S LARGEST PARK RENOVATION. C. SAFETY NET PARTNERSHIPS THE OHIO HEALTH PLAN DONATED APPROXIMATELY $157 THOUSAND TO SUPPORT SAFETY NET PROVIDERS THROUGH ITS THRIVING COMMUNITIES GRANT PROGRAM. THE FOLLOWING ARE TWO EXAMPLES OF THE KINDS OF PROJECTS FUNDED UNDER THIS STREAM OF WORK: - THROUGH THE THRIVING COMMUNITITES GRANTS PROGRAM, OHIO HEALTH PLAN DISTRIBUTED APPROXIMATELY $146 THOUSAND IN GRANTS TO SAFETY NET ORGANIZATIONS IN 2012 TO SUPPORT THEIR WORK SERVING UNINSURED POPULATIONS. THESE CONTRIBUTIONS WERE USED FOR BOTH PROGRAMMATIC AND GENERAL OPERATING SUPPORT. - THE INSTITUTE FOR HEALTHCARE IMPROVEMENT (IHI) IS A LEADING INNOVATOR IN HEALTH AND HEALTH CARE IMPROVEMENT. THE OHIO HEALTH PLAN MANAGES A LARGE SCHOLARSHIP POOL FOR SAFETY NET PROVIDERS, AND RECRUITED LOCALLY TO SUBSIDIZE TRVEL AND LODGING COSTS FOR THESE PARTNERS TO ATTEND IHI PROGRAMS AND FORUMS. IN 2012, APPROXIMATELY $5,400 WAS PROVIDED TO ORGANIZATIONS UNDER THESE GRANTS. D. DEVELOPING AND DISSEMINATING KNOWLEDGE IN 2012, THE OHIO HEALTH PLAN SPENT MORE THAN $938 THOUSAND TO SUPPORT PROGRAMS AND SERVICES FOR THE DEVELOPMENT AND DISSEMINATION OF KNOWLEDGE TO NONPROFIT ORGANIZATIONS. THE FOLLOWING ARE THREE OF THE WAYS IN WHICH THE OHIO HEALTH PLAN CONTRIBUTED TO THE DISSEMINATION OF KNOWLEDGE DURING THE YEAR. 1. EDUCATIONAL THEATRE PROGRAMS (ETP) THE OHIO HEALTH PLAN'S EDUCATIONAL THEATRE PROGRAM IS BASED UPON A MODEL FOR PROMOTING HEALTH THROUGH THEATRE. KP STAFF COLLABORATE WITH THE CLEVELAND METROPOLITAN SCHOOL DISTRICT TO TRAIN STUDENT ACTORS AS HEALTH EDUCATION AMBASSADORS AND IN TURN DELIVER HEALTH MESSAGES TO A BROADER AUDIENCE OF PEERS. THE PROGRAM IS COMPRISED OF THREE PRODUCTIONS FOCUSED ON HIV/AIDS AND OTHER SEXUALLY TRANSMITTED DISEASES; THE IMPORTANCE OF GOOD NUTRITION AND EXERCISE; AND CONFLICT RESOLUTION AND VIOLENCE PREVENTION. APPROXIMATELY 49 HIGH SCHOOL STUDENTS WORKED AS ACTORS IN THE THREE PRODUCTIONS; AND PRESENTED 33 PERFORMANCES REACHING A COMBINED AUDIENCE OF OVER 6,500 PEOPLE IN 2012. 2. HEALTH CARE TRAINING &amp; EDUCATION PROGRAMS OHIO HEALTH PLAN SUPPORTS TWO RESIDENTS UNDER THE PHARMACY RESIDENCY PROGRAM. RESIDENCY EXPERIENCES INCLUDE ADULT PRIMARY CARE MEDICINE, AND SEVERAL CLINICS CONCENTRATING ON GERIATRIC, LIPID, ANTICOAGULATION, AND GROWTH FACTORS. ADDITIONAL SUBJECTS INCLUDE FORMULARY MANAGEMENT, DRUG INFORMATION, PHARMACY ADMINISTRATION, AND PHARMACY CALL CENTERS. THE RESIDENCIES ARE AFFILIATED WITH THE NORTHEASTERN OHIO UNIVERSITY COLLEGE OF PHARMACY TO OFFER A UNIQUE TEACHING OPPORTUNITY FOR ON-CAMPUS LECTURES AND SMALL-GROUP LEARNING. THE RESIDENCY STRUCTURE IS FLEXIBLE IN ORDER TO ALLOW FOR SEVERAL MONTHS OF ELECTIVE ROTATIONS, PERMITTING RESIDENTS TO BECOME WELL-ROUNDED PRACTITIONERS. 3. GRANTS AND DONATIONS FOR KNOWLEDGE DISSEMINATION IN 2012, A GRANT IN THE AMOUNT OF APPROXIMATELY $198 THOUSAND WAS MADE TO THE CLEVELAND STATE UNIVERSITY FOUNDATION TO UNDERWRITE THE FULL COST OF ONE YEAR OF THE CAREERS IN HEALTH AND MEDICAL PROFESSIONS (CHAMPS) PROGRAM. CHAMPS SERVES AS AN ENTRY POINT FOR A PIONEERING SERVICE MODEL FOR URBAN PRIMARY CARE. THE MODEL ESTABLISHES AN EDUCATIONAL PIPELINE AND INCLUDES 35 STATE-FUNDED SCHOLARSHIPS FOR STUDENTS WHO COMMIT TO ESTABLISHING PRACTICES IN ONE OF CLEVELAND'S MEDICALLY UNDER-SERVED NEIGHBORHOODS AFTER COMPLETING THEIR RESIDENCIES. E. OTHER COMMUNITY BENEFIT INVESTMENTS DURING 2012, THE OHIO HEALTH PLAN SPENT APPROXIMATELY $448 THOUSAND ON OTHER COMMUNITY BENEFIT PROGRAMS AND ACTIVITIES BEYOND THE NATIONAL STREAMS OF WORK. INVESTMENTS INCLUDED ADMINISTRATIVE COSTS SUCH AS THE LABOR AND NON-LABOR EXPENSES NECESSARY FOR THE CONTINUING OPERATIONS OF THE COMMUNITY BENEFIT PROGRAMS IN THE STATE OF OHIO. THE FOLLOWING ARE EXAMPLES OF TWO ACTIVITIES UNDERTAKEN TO SUPPORT THE COMMUNITIES WE SERVE DURING THE YEAR. - THE Y.O.U. PROGRAM OFFERS ECONOMICALLY DISADVANTAGED HIGH SCHOOL STUDENTS IN OHIO WITH SUPPORTIVE AND MEANINGFUL EMPLOYMENT EXPERIENCES IN THE HEALTH CARE FIELD. EMPLOYMENT IS DURING THE SUMMER MONTHS WHEN STUDENTS ARE EXPOSED TO A VARIETY OF DIFFERENT DEPARTMENTS THROUGHOUT THE ORGANIZATION. - THE INROADS PROGRAM FOCUSES ON DEVELOPING MINORITY COLLEGE STUDENTS FOR LEADERSHIP ROLES IN BUSINESS AND IN THE COMMUNITY. STUDENT INTERNS TYPICALLY WORK TWO TO FIVE SUMMERS AT KAISER PERMANENTE WITH THE GOAL OF OBTAINING PERMANENT PLACEMENT UPON GRADUATION FROM COLLEGE.</Explanation>
      </GeneralExplanation>
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