2015-11-11T17:31:11-06:00 2012-12-31 PRICEWATERHOUSECOOPERS LLP 2001 MARKET STREET SUITE 1800 PHILADELPHIA PA 19103 990 2012-01-01 943299123 CAMP BOWIE SERVICE CENTER % VP - NATIONAL TAX COMPLIANCE CAMP 5102716611 ONE KAISER PLAZA OAKLAND CA 94612 ALPHONSE UPSHAW 5102716385 2015-11-10 2673303000 2012 2016-04-25 22:37:26Z X GERARD L COY ONE KAISER PLAZA 15L OAKLAND CA 94612 65022146 false X N/A X 1998 CA CAMP BOWIE SERVICE CENTER PROVIDES MEMBERSHIP ACCOUNTING AND ADMINISTRATIVE SUPPORT SERVICES TO THE AFFILIATED EXEMPT ORGANIZATIONS THAT COMPRISE THE KAISER PERMANENTE MEDICAL CARE PROGRAM. 3 0 0 0 0 0 0 32709734 65022146 15483 0 0 0 32725217 65022146 0 0 0 0 18841237 52594536 0 0 0 13864974 13809979 32706211 66404515 19006 -1382369 19227564 18701993 20856108 21930436 -1628544 -3228443 CAMP BOWIE SERVICE CENTER PROVIDES MEMBERSHIP ACCOUNTING AND ADMINISTRATIVE SUPPORT SERVICES TO THE AFFILIATED EXEMPT ORGANIZATIONS THAT COMPRISE THE KAISER PERMANENTE MEDICAL CARE PROGRAM. false false 66404515 65022146 PROCESS INDIVIDUAL AND GROUP MEMBERSHIP RECORDS AND DUES, MANAGE COLLECTIONS AND RECEIVABLES AND PROVIDE CALL CENTER SUPPORT FOR THE MEMBERS OF THOSE AFFILIATED ORGANIZATIONS THAT COMPRISE THE KAISER PERMANENTE MEDICAL CARE PROGRAM. 66404515 true false false false false false false false false false true false false true true false false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true X 0 0 0 false false false false false false false false false false X 3 0 false false false false true true true true true false false true true true true true true true true false CA X X VP - NATIONAL TAX COMPLIANCE 5102716385 ONE KAISER PLAZA 15L OAKLAND CA 94612 X Arthur M Southam 4.0 46.0 X 0 3350376 119108 Bernard J Tyson 1.0 49.0 X 0 4087093 246726 Donna Lynne 1.0 49.0 X 0 1109779 461663 Deborah Stokes 0.3 49.7 X 0 690493 184332 Gerard L Coy 10.0 40.0 X 0 739887 141229 Kathryn Lancaster 1.0 49.0 X 0 2779989 235528 Thomas R Meier 0.0 50.0 X 0 816082 125506 Victoria B Zatkin 0.5 49.5 X 0 339271 192592 Mark S Zemelman 0.0 50.0 X 0 1019066 181919 Charles Kirschbaum 50.0 0.0 X 0 142211 31513 Barbara Ishikawa 50.0 0.0 X 0 322578 90729 Dennis Sentz 20.0 30.0 X 0 301391 89527 Scott R Taylor 50.0 0.0 X 0 88597 28138 Russ Herold 50.0 0.0 X 0 146609 27214 Calvin S Striggles 50.0 0.0 X 0 104165 37472 0 16037587 2193196 0 false true false FISERV OUTPUT SOLUTIONS 13100 N PROMENADE BLVD STAFFORD TX 77477 PRINTING & DUPL. SVC 587064 KFORCE Inc PO Box 277997 ATLANTA GA 303847997 O/S PERSONNEL 440101 DELL COMPUTER CORPORATION 2300 WEST PLANO PARKWAY PO BOX 2 PLANO TX 750269005 O/S OTHER MISC. SVCS 1437870 NATIONAL ASSOCIATES INC 1130 CONNECTICUT AVENUE NW SUITE 5 WASHINGTON DC 20036 O/S PERSONNEL 984541 KORAK HEALTHCARE SOURCE 2209 COMMERCE ROAD SUITE 4 FOREST HILL MD 210502539 O/S PERSONNEL 298100 8 0 MEMBERSHIP SERVICE 561499 65022146 65022146 65022146 0 0 0 0 0 0 0 0 0 0 0 65022146 65022146 0 0 0 0 0 0 35715498 35715498 0 0 85892 85892 13325065 13325065 3468081 3468081 0 0 0 0 0 0 0 0 934596 934596 0 0 2213448 2213448 238339 238339 0 88240 88240 0 396966 396966 3058264 3058264 0 OUTSIDE MEDICAL SERVICES 453085 453085 EQUIPMENT RENTAL 824393 824393 OUTSIDE NON-MEDICAL SERVICES 5122908 5122908 SUPPLIES- PHARMACY,MEDICAL,ETC 196188 196188 283552 283552 66404515 66404515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224055 226184 20198190 6304053 12770917 13894137 0 0 0 0 0 0 0 0 6232592 4581672 19227564 18701993 229811 740040 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20626297 21190396 20856108 21930436 X 0 0 0 0 -1628544 -3228443 -1628544 -3228443 19227564 18701993 X -1382369 -217530 X false true X true false X X X false false false KAISER FOUNDATION HEALTH PLAN INC 941340523 09 true true true 33904918 KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST 930798039 09 true true true 7985387 KASIER FOUNDATION HEALTH PLAN OF COLORADO 840591617 09 true true true 11301361 KAISER FOUNDATION HEALTH PLAN OF GEORGIA 581592076 09 true true true 3762040 KAISER FOUNDATION HEALTH PLAN OF OHIO 340922268 09 true true true 1448317 KFHP OF THE MID-ATLANTIC STATES INC 520954463 09 true true true 4744278 6 63146301 Camp Bowie provides membership accounting and administrative support to Kaiser Foundation Health Plan Inc and its subsidiaries 11417246 3032766 8384480 5877193 2761511 3115682 2903751 509776 2393975 13894137 DUE FROM AFFILIATED ORG 4581672 4581672 0 ACCRUED BONUS 301957 PENSION/BENEFIT PLAN PAYABLE 1179809 DUE TO AFFILIATES 18071217 LT DEFERRED RENT 794795 SEVERENCE/POST EMPLOYMENT BENEFITS 842618 21190396 false true false false false false false true false Arthur M Southam 0 755588 0 1530102 0 1064686 0 97089 0 22019 0 3469484 0 333769 Bernard J Tyson 0 932699 0 2087352 0 1067042 0 221647 0 25079 0 4333819 0 449238 Deborah Stokes 0 347253 0 278496 0 64744 0 167539 0 16793 0 874825 0 43578 Donna Lynne 0 491921 0 577175 0 40683 0 445950 0 15713 0 1571442 0 0 Gerard L Coy 0 360104 0 362859 0 16924 0 124247 0 16982 0 881116 0 0 Kathryn Lancaster 0 650287 0 1297450 0 832252 0 221210 0 14318 0 3015517 0 261310 Thomas R Meier 0 318951 0 459975 0 37156 0 98090 0 27416 0 941588 0 1075 Victoria B Zatkin 0 196294 0 106133 0 36844 0 189027 0 3565 0 531863 0 3175 Russ Herold 0 122271 0 22650 0 1688 0 19091 0 8123 0 173823 0 0 Charles Kirschbaum 0 120994 0 19411 0 1806 0 17602 0 13911 0 173724 0 0 Barbara Ishikawa 0 191281 0 72720 0 58577 0 74943 0 15786 0 413307 0 0 Mark S Zemelman 0 465119 0 387152 0 166795 0 159780 0 22139 0 1200985 0 126344 Dennis Sentz 0 176586 0 100441 0 24364 0 74297 0 15230 0 390918 0 0 Schedule J, Part I, Line 3 All officers, directors and employees performing services for Camp Bowie Service Center (CBSC) are employees of other Kaiser organizations. CBSC is recharged by other Kaiser organizations for employees' time. CBSC currently utilizes 814 employees of other Kaiser organizations. Camp bowie service center relied on a related organization 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. Schedule J, Part I, Line 4a Severance Payment 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. Schedule J, Part I, Line 4b Supplemental Nonqualified Retirement Plan Payment Kathryn Lancaster $ 790,314 Thomas Meier 1,075 Deborah Stokes 43,578 Arthur M. Southam 1,021,889 Bernard J. Tyson 1,036,741 Mark S. Zemelman 126,344 Victoria Zatkin 3,175 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. Schedule J, Part I, Line 7 Non-Fixed Payments 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. Form 990, Heading, Item B, Amended Return Part VII and Schedule J of the return have been amended to reflect updated compensation information regarding certain deferred compensation calculations. Form 990, Part V, Line 2 All officers, directors and employees performing services for Camp Bowie Service Center (CBSC) are employees of other Kaiser organizations. CBSC is recharged by other Kaiser organizations for employees' time. CBSC currently utilizes 814 employees of other Kaiser organizations. Form 990, Part VI, Line 6 Kaiser Foundation Health Plan, Inc. is the sole member. Form 990, Part VI, Line 7a Kaiser Foundation Health Plan, Inc. appoints the directors (and fills vacancies and has authority to remove directors). Form 990, Part VI, Line 7b The single member, Kaiser Foundation Health Plan, Inc., could have approval over goveranance decisions. Form 990, Part VI, Line 11b Form 990 REVIEW PROCESS 1. KEY INFORMATION IS OBTAINED AND/OR CONFIRMED WITH INTERNAL SOURCES INCLUDING REGIONAL FINANCE AND EXECUTIVE COMPENSATION. 2. Prior to finalization, the return is reviewed with a PRICEWATERHOUSECOOPERS LLP tax advisor. 3. once signed by a PRICEWATERHOUSECOOPERS LLP tax advisor, the return and underlying data are reviewed by an officer or a member of management designated by an officer for signature and filing. 4. Copies are then provided to Board Members prior to filing. Form 990, Part VI, Line 12c Compliance Enforcement 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 Chief Compliance Officer and the SVP of 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. Form 990, Part VI, Line 15a/b Compensation Determination The executive compensation program as administered by Kaiser Foundation Health Plan, Inc. 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 & 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. Form 990, Part VI, Line 18 Forms 990 are available on www.guidestar.org. Form 990, Part VI, Line 19 Governing documents, Conflict of Interest Policy - are available upon request as disclosed to other regulatory bodies. To request copies contact: Vice President - National Tax Compliance Kaiser Foundation Health Plan and Hospitals One Kaiser Plaza, Suite 15L Oakland, CA 94612 Form 990, Part VII, Section A, Column B 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. 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