2014-11-12T13:27:31-06:00 2013-12-31 PRICEWATERHOUSECOOPERS LLP 2001 MARKET ST SUITE 1700 PHILADELPHIA PA 19103 990 2013-01-01 930798039 KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST % VP - TAX SERVICES KAIS 5102716611 ONE KAISER PLAZA 15L Suite OAKLAND CA 94612 DEBORAH STOKES SVP, CC and CAO 5102716385 2014-11-11 ROBERT W FRIZ P00438748 5102716385 2013 2015-11-30 17:44:51Z ANDREW R MCCULLOCH ONE KAISER PLAZA 15L OAKLAND CA 94612 3662501705 false X N/A X 1984 OR TO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE. 15 12 7746 105 6496000 55792 90559 2980226987 3143279380 21388816 18066444 24579465 25188579 3026251060 3186624962 299224 280075 0 0 775841514 795598531 0 0 0 2231922859 2363425456 3008063597 3159304062 18187463 27320900 1260245683 1333718570 1206822295 911194558 53423388 422524012 X TO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE. false false 2900978224 127535 3109885299 MEMBER HEALTH CARE SERVICES AND MEDICAL TRAINING FOR CARE IMPROVEMENT KAISER FOUNDATION HEALTH PLAN OF NORTHWEST (KFHP OF NORTHWEST) PROVIDES HOSPITAL, 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 NORTHWEST EDUCATES AND TRAINS MEDICAL STUDENTS AND OTHER HEALTH CARE PROFESSIONALS AND PROMOTES SCIENTIFIC AND NURSING EDUCATION IN ORDER TO IMPROVE CARE. ADDITIONAL INFORMATION ABOUT NORTHWEST HEALTH PLAN'S CHARITABLE ACTIVITIES CAN BE FOUND IN SCHEDULE O. 76681788 0 33003879 Medicaid and Other Government Sponsored Programs Kaiser Foundation Health Plan of the Northwest (KFHP) is committed to improving medical care for beneficiaries of Medicaid and other government sponsored programs, not only for KFHP members, but also within the communities we serve. At the end of 2013, more than 14,000 individuals were receiving the benefits of full membership in KFHP's Medicaid managed care program. Approximately 3,000 more individuals were members of the Children's Health Insurance Program (CHIP). In addition, KFHP provided health care on a fee-for-service basis for Medicaid beneficiaries who were not enrolled as KFHP members. ADDITIONAL INFORMATION ABOUT NORTHWEST HEALTH PLAN'S CHARITABLE ACTIVITIES CAN BE FOUND IN SCHEDULE O. 23573322 0 390202 Charitable Care (Medical Financial Assistance and Charitable Health Coverage) Kaiser Foundation Health Plan of the Northwest (KFHP) provides charity care to low-income vulnerable patients through the Medical Financial Assistance (MFA) and Charitable Health Coverage (CHC) Programs. KFHP offers financial assistance through the MFA program to help families and individuals with a demonstrated financial need pay for all or part of the cost of emergency or medically necessary care provided in Kaiser Permanente facilities and/or by Kaiser Permanente providers. In 2013, this program assisted nearly 13,000 qualifying applicants. The CHC program offers regular Kaiser Foundation Health Plan membership at minimal cost to low income families who are not eligible for other public or privately sponsored coverage. More than 4,500 individuals were receiving comprehensive health care through this program at the end of 2013. ADDITIONAL INFORMATION ABOUT NORTHWEST HEALTH PLAN'S CHARITABLE ACTIVITIES CAN BE FOUND IN SCHEDULE O. 1980290 152540 0 SEE SCHEDULE O COMMUNITY BENEFIT REPORT 1980290 152540 0 3003213624 true true false true false false false false false false true false false true true false true true false false false false false false false false false true false true false false false false false false false false false false false false true true true true false false true 4128 0 true 7746 true true true false false false false false false false false false X 15 12 false false false false true true true true true false false true true true true true true true true false OR WA X X VP - TAX SERVICES 5102716385 ONE KAISER PLAZA 15L OAKLAND CA 94612 X Christine K Cassel Director 1.0 13.0 X 0 189000 0 Thomas W Chapman Director 1.0 13.0 X 0 197476 17500 Jeffrey E Epstein Director 0.5 4.5 X 0 124090 0 Daniel P Garcia SVP, Chief Compliance Officer 2.0 48.0 X 0 1424478 56135 William R Graber Director 1.0 6.5 X 0 231153 0 J Eugene Grigsby Director 1.0 7.5 X 0 206425 0 George C Halvorson Chairman 5.0 45.0 X X 0 10049725 146207 Judith Johansen Director 0.5 6.8 X 0 231370 0 Kim J Kaiser Director 0.5 8.0 X 0 214808 0 Philip Marineau Director 0.58 6.44 X 0 211230 0 Jenny J Ming Director 0.3 4.8 X 0 207633 0 Edward YW Pei Director 0.5 7.25 X 0 192630 17500 Margaret E Porfido Director 1.0 5.5 X 0 229752 0 Cynthia Telles Director 0.5 6.6 X 0 225539 0 Bernard J Tyson CEO & President 5.0 45.0 X X 0 4150020 139874 Erin M Downing Assistant Secretary 4.0 46.0 X 0 95076 14143 Jennifer Gardner Special Assistant to the board 4.0 46.0 X 0 90505 15348 Kathryn Lancaster EVP & CFO 4.0 46.0 X 0 2196752 141775 Donna Lynne EVP, Group & REG President 4.0 46.0 X 0 1236958 413628 Andrew R McCulloch Region President - Northwest 25.0 25.0 X 0 1045155 386072 Thomas R Meier SVP & Treasurer 2.0 48.0 X 0 1047162 44749 Donald H Orndoff SVP, NFS 5.0 45.0 X 0 929854 170182 Jacqueline Sellers Assistant Secretary 5.0 45.0 X 0 248419 3983 Arthur M Southam EVP, Health Plan Operations 4.0 46.0 X 0 2609154 45573 Deborah Stokes SVP, CC & CAO 4.0 46.0 X 0 764912 -2441 William N Wiechmann Assistant Secretary 50.0 0.0 X 0 412528 60618 Victoria B Zatkin VP, Off of brd & Corp gov svc 4.0 46.0 X 0 330156 13335 Mark S Zemelman SVP, Gen Counsel & Secretary 2.0 48.0 X 0 1323548 43660 Mark A Charpentier VP, Mktg, Sls & Bus Devel 30.0 20.0 X 0 552735 91183 Mark M Enger VP, Chief Operations Officer 30.0 20.0 X 0 971297 53405 Susan M Hennessy VP, Strategic Planning & Hlth 30.0 20.0 X 0 712016 42119 Susan E Mullaney VP, HOSPITAL OPERATIONS 30.0 20.0 X 0 374863 73415 Karen L Schartman VP & CFO 30.0 20.0 X 0 504900 41554 Stephen Shawn Barton Exec Dir, Revenue Cycle - nw 50.0 0.0 X 0 338914 45714 Mary L Durham VP, The Center Health Research 30.0 20.0 X 0 379479 55687 Michael E Kinard VP, Ambulatory Care Svc 30.0 20.0 X 0 394841 27168 Richie E Smith VP, HR - NW 30.0 20.0 X 0 412594 94288 Kenneth R Wright VP, Dental Care Svcs - nw 50.0 0.0 X 0 340282 79546 0 35397429 2331920 1079 false true false KAISER FOUNDATION HOSPITALS 500 NE MULTNOMAH ST PORTLAND OR 97232 HOSPITAL SERVICES 711075713 NORTHWEST PERMANENTE PC 500 NE MULTNOMAH STREET PORTLAND OR 97232 MEDICAL SERVICES 515030807 PERMANENTE DENTAL ASSOCIATES 500 NE MULTNOMAH STREET PORTLAND OR 97232 DENTAL SERVICES 41195766 DSI JACKSON SOUTH PO BOX 402946 ATLANTA GA 30384 DIALYSIS/MEDICAL SVC 11354975 PACIFIC NORTHWEST RENALS PO BOX 53034 PHOENIX AZ 85072 DIALYSIS/MEDICAL SVC 6536959 165 90559 90559 MBR HLTH CARE PREM 621400 2244516761 2244516761 SUPPL CHARGE/PHARM 621400 156964656 150474812 6489844 NON-PLAN & IND REV 621400 9382980 9382980 OTHER PRGRM SERV 621400 20874447 20874447 MEDICARE 621400 711540536 711540536 3143279380 14033926 14033926 0 0 436376 56327 380049 0 380049 6156 373893 479722436 130497 475650669 169747 4071767 -39250 4032518 4032518 0 0 0 MISC REVENUE 900099 24808530 24808530 24808530 3186624962 3136789536 6496000 43248867 280075 280075 0 0 0 0 0 502209922 465666708 36543214 0 98721486 98721486 153442555 153111112 331443 41224568 21222244 20002324 0 1416252 1416252 1277407 1277407 404145 404145 0 710021 710021 356881741 331001153 25880588 6660465 2543998 4116467 7561807 6411080 1150727 154578570 127540752 27037818 0 13939559 13939505 54 3464893 2921931 542962 0 999331 999331 10749 10749 0 33840768 33840768 18569175 18569057 118 MEDICAL SERVICE PAYMENTS 1244451240 1244451240 SUPPLIES 366639822 339187950 27451872 INTER-REGIONAL CHARGES 95011649 89119259 5892390 HIGH-RISK INSURANCE POOL COSTS 18242248 18242248 38765614 36432309 2333305 3159304062 3003213624 156090438 0 11907229 4967406 0 0 0 0 73376649 74349559 0 0 0 0 0 0 23535216 29645461 4597015 5804290 663221902 387322869 252603642 275899033 837796467 867947473 0 0 0 0 0 0 56429465 75105348 1260245683 1333718570 158741885 167404966 0 0 30359339 30230560 0 0 0 0 0 0 0 0 0 0 1017721071 713559032 1206822295 911194558 X 4712722 4712722 0 0 48710666 417811290 53423388 422524012 1260245683 1333718570 X 27320900 -6860564 348640288 X false true X true false X 0 56498 34240 55792 90559 237089 2573087902 2682950846 2817773409 2980226987 3143279380 14197318524 0 0 0 2573087902 2683007344 2817807649 2980282779 3143369939 14197555613 0 0 0 14197555613 26785941 22587692 19185497 16369318 14364423 99292871 0 26785941 22587692 19185497 16369318 14364423 99292871 0 0 2599873843 2705595036 2836993146 2996652097 3157734362 14296848484 0.99306 0.99153 0.00694 0.00847 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false true false false false true 84082 true 208037 true 26005 true 86021 404145 false Schedule C, Part II-B, Lines 1a through 1i 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, THE BROADER COMMUNITY 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 ANY OF HEALTH PLAN'S RESOURCES BEING USED IN ANY POLITICAL CAMPAIGNS. THIS POLICY IS CLOSELY MONITORED FOR COMPLIANCE. DURING THE YEAR THIS ORGANIZATION MADE COMMENTS OR STATEMENTS CONCERNING LEGISLATION AND BALLOT INITIATIVES WHICH MAY AFFECT THE HEALTH CARE INDUSTRY. HEALTH PLAN 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, ITS MEMBERS AND ITS PATIENTS BY PERFORMING THE FOLLOWING ACTIVITIES: - 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 AND THE BROADER COMMUNITY IN A COST EFFECTIVE MANNER. - 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. - PREPARING WRITTEN AND ORAL TESTIMONY, APPEARING AT LEGISLATIVE HEARINGS, MONITORING LEGISLATIVE PROCEEDINGS AND MEETING WITH LEGISLATORS AND/OR THEIR STAFFS REGARDING ISSUES PERTINENT TO THE MISSION OF HEALTH PLAN. 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 AND PATIENTS OF HEALTH PLAN. 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. 31777408 31777408 423354118 260563153 162790965 23002822 15189639 7813183 150056038 101349605 48706433 35031516 10220472 24811044 275899033 DUE FROM AFFILIATES 74223616 OTHER CURRENT ASSETS 881732 75105348 0 SELF-INSURED RISK - PPL 68287840 SELF-INSURED RISK - AUTO & UNE 396000 SELF-INSURED RISK - WORKERS CO 4416694 POST RETIREMENT BENEFIT-LT 606681547 POST RETIREMENT BENEFIT-CURRT 12642715 OTHER LIABILITIES 21134236 713559032 3527850437 -6860564 354739081 347878517 3179971920 6653042 6653042 3186624962 3158749810 8343472 8343472 3150406338 710021 8187703 8897724 3159304062 Schedule D, Part X, Line 2 FIN 48 Footnote: THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE UNDER FIN 48. Schedule D, Part XI, Line 2d Change in Other Comprehensive Income $ 353,897,875 Gain/loss on investments - book 4,962,197 Gain/Loss on sale of fixed assets - book 0 OTTI Losses ( See Note 1) (6,148,014) Inter-entity revenue reclass 10,924,747 Investment Management Fee Reclass <710,021> Bad Debt expense reclass (8,187,703) TOTAL $ 354,739,081 Note 1: Other than temporary impairment (OTTI) of investment recognized for financial statement purposes, which will be tax reported when realized. Schedule D, Part XI, Line 4b Gain/loss on sale of investments - tax $ 4,071,767 Gain/loss on sale of fixed assets - tax (39,249) Rental revenue reclass (56,327) Miscellaneous revenue reclass 2,676,851 Total $ 6,653,042 Schedule D, Part XII, Line 2d Inter-entity Expense reclass 10,924,747 Gain/loss on sale of fixed assets - reclass 39,249 Misc Expenses reclass (2,676,851) RENTAL EXPENSES RECLASS 56,327 Total $ 8,343,472 Schedule D, Part XII, Line 4b Bad Debt expense reclass $ 8,187,703 true American Heart Association 4380 SW Macadam Ave Ste 480 Portland OR 97239 135673797 501(c)(3) 39420 fundraiser American Lung Association 7420 SW Bridgeport Rd Ste 200 Portland OR 97224 930386887 501(c)(3) 16000 fundraiser Community Action Organization 1001 SW Baseline Street Hillsboro OR 97123 930554941 501(c)(3) 15000 fundraiser Familias en Accion 2710 NE 14th Ave Portland OR 97212 931284335 501(c)(3) 10000 fundraiser March of Dimes 1220 SW Morrison Ste 510 Portland OR 97205 131846366 501(c)(3) 18000 fundraiser Oregon Area Jewish Committee 7410 SW Oleson Rd Portland OR 97223 261871211 501(c)(3) 5100 fundraiser Oregon School Based Health Care 310 SW Fourth Ave Suite 905 Portland OR 97204 364588857 501(c)(3) 7500 fundraiser Portland Schools Foundation 2069 NE Hoyt St Portland OR 97232 931149789 501(c)(3) 9600 fundraiser Susan G Komen 1500 SW 1st Ave Suite 270 Portland OR 97201 931068897 501(c)(3) 25000 fundraiser Upstream Public Health 240 N Broadway Portland OR 97214 421579435 501(c)(3) 50000 General Op Support North Clackamas School District 4444 SE Lake Rd 950 Milwaukie OR 97222 930599524 Government 22000 Project Support 11 0 Schedule I, Part I, Question 2 At the end of their funding cycle grantees are required to submit a final REPORT WHICH DELINEATES ACCOMPLISHMENTS RELATED TO STATED OBJECTIVES. LARGE GRANTS (TYPICALLY OVER $100,000) MAY REQUIRE QUARTERLY PROGRESS REPORTS. false true false false false false false true false Stephen Shawn Barton Exec Dir, Revenue Cycle - nw 0 219410 0 115877 0 3627 0 22428 0 23286 0 384628 0 0 Christine K Cassel Director 0 189000 0 0 0 0 0 189000 0 0 Thomas W Chapman Director 0 197476 0 0 0 17500 0 0 214976 0 0 Mark A Charpentier VP, Mktg, Sls & Bus Devel 0 236018 0 201655 0 115062 0 71022 0 20161 0 643918 0 79492 Mary L Durham VP, The Center Health Research 0 210569 0 132771 0 36139 0 34472 0 21215 0 435166 0 0 Mark M Enger VP, Chief Operations Officer 0 39112 0 257489 0 674696 0 36732 0 16673 0 1024702 0 226353 Daniel P Garcia SVP, Chief Compliance Officer 0 572755 0 802546 0 49177 0 25730 0 30405 0 1480613 0 0 William R Graber Director 0 231153 0 0 0 0 0 231153 0 0 J Eugene Grigsby Director 0 206425 0 0 0 0 0 206425 0 0 George C Halvorson Chairman 0 1302727 0 7147272 0 1599726 0 112605 0 33602 0 10195932 0 0 Susan M Hennessy VP, Strategic Planning & Hlth 0 300033 0 236476 0 175507 0 19005 0 23114 0 754135 0 0 Judith Johansen Director 0 231370 0 0 0 0 0 231370 0 0 Kim J Kaiser Director 0 214808 0 0 0 0 0 214808 0 0 Michael E Kinard VP, Ambulatory Care Svc 0 262981 0 115679 0 16181 0 8206 0 18962 0 422009 0 0 Kathryn Lancaster EVP & CFO 0 676598 0 1210688 0 309466 0 125720 0 16055 0 2338527 0 266810 Donna Lynne EVP, Group & REG President 0 522385 0 671301 0 43272 0 386467 0 27161 0 1650586 0 0 Philip Marineau Director 0 211230 0 0 0 0 0 211230 0 0 Andrew R McCulloch Region President - Northwest 0 406081 0 598748 0 40326 0 361680 0 24392 0 1431227 0 0 Thomas R Meier SVP & Treasurer 0 325824 0 438610 0 282728 0 14386 0 30363 0 1091911 0 244843 Jenny J Ming Director 0 207633 0 0 0 0 0 207633 0 0 Susan E Mullaney VP, HOSPITAL OPERATIONS 0 273374 0 86485 0 15004 0 47107 0 26308 0 448278 0 0 Donald H Orndoff SVP, NFS 0 401454 0 505726 0 22674 0 143813 0 26369 0 1100036 0 0 Edward YW Pei Director 0 192630 0 0 0 17500 0 0 210130 0 0 Margaret E Porfido Director 0 229752 0 0 0 0 0 229752 0 0 Karen L Schartman VP & CFO 0 286442 0 202094 0 16364 0 23738 0 17816 0 546454 0 0 Jacqueline Sellers Assistant Secretary 0 187644 0 55237 0 5538 0 -7251 0 11234 0 252402 0 0 Richie E Smith VP, HR - NW 0 264166 0 132464 0 15964 0 69886 0 24402 0 506882 0 0 Arthur M Southam EVP, Health Plan Operations 0 775034 0 1476834 0 357286 0 22139 0 23434 0 2654727 0 311627 Deborah Stokes SVP, CC & CAO 0 346256 0 347325 0 71331 0 -22132 0 19691 0 762471 0 50089 Cynthia Telles Director 0 225539 0 0 0 0 0 225539 0 0 Bernard J Tyson CEO & President 0 1094700 0 2373012 0 682308 0 111774 0 28100 0 4289894 0 555429 William N Wiechmann Assistant Secretary 0 238936 0 157178 0 16414 0 36568 0 24050 0 473146 0 0 Kenneth R Wright VP, Dental Care Svcs - nw 0 228999 0 92533 0 18750 0 51485 0 28061 0 419828 0 0 Victoria B Zatkin VP, Off of brd & Corp gov svc 0 200385 0 91393 0 38378 0 8542 0 4793 0 343491 0 0 Mark S Zemelman SVP, Gen Counsel & Secretary 0 493974 0 632158 0 197416 0 17865 0 25795 0 1367208 0 155249 Schedule J, Part I, line 3 Kaiser foundation health plan of the northwest 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. Schedule J, Part I, Line 4a SEVERANCE PAYMENTS: Mark M. Enger $ 443,920 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: Mark Charpentier $ 79,492 Mary Durham 923 Mark Enger 226,353 George Halvorson 1,500,000 Susan Hennessy 155,289 Kathryn Lancaster 267,106 Thomas Meier 246,161 Arthur Southam 314,156 Deborah Stokes 50,089 Bernard Tyson 555,429 Victoria Zatkin 2,976 Mark Zemelman 156,419 SOME OF THE PARTICIPANTS LISTED IN SCHEDULE J, PART II PARTICIPATED IN NONQUALIFIED SUPPLEMENTAL RETIREMENT PLANS. UNDER THESE PLANS, THE ORGANIZATION MAKES ANNUAL CONTRIBUTIONS TO A NOTIONAL ACCOUNT ON BEHALF OF EACH PARTICIPANT. CONTRIBUTIONS VARY BY POSITION, LEVEL AND PAY, AND VEST OVER TIME BASED ON AGE AND/OR SERVICE. PARTICIPANT ACCOUNTS ARE CREDITED WITH A FIXED RATE OF INTEREST, INVESTED IN AVAILABLE MUTUAL FUNDS OR A COMBINATION OF BOTH. CERTAIN OFFICERS ACCRUE A BENEFIT THAT VESTS BASED ON AGE AND SERVICE AND TARGETS A PERCENTAGE OF FINAL AVERAGE PAY LESS PRIOR PLAN OFFSETS. 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. Schedule J, Part II, Column C The actuarial value for some individuals' defined benefit plan declined in 2013, resulting in negative values in column (C) in some instances. Form 990, Part III, Lines 4a - 4d 2013 Community Benefit Report KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST'S COMMITMENT TO THE COMMUNITY KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (NORTHWEST HEALTH PLAN OR KFHP-NW) PROVIDES AND ARRANGES COMPREHENSIVE HEALTH CARE SERVICES FOR MEMBERS ON A PREDOMINANTLY PREPAID BASIS. ITS CONTRACTUAL OBLIGATIONS TO GROUP AND INDIVIDUAL MEMBERS ARE FULFILLED BY CONTRACTING WITH KAISER FOUNDATION HOSPITALS AND PERMANENTE PHYSICIANS TO PROVIDE THE REQUIRED HEALTH CARE SERVICES. KFHP-NW STRIVES FOR EXCELLENCE IN SERVING ITS MEMBERS THROUGH MARKET-LEADING PERFORMANCE IN QUALITY AND SERVICE. AS A SUBSIDIARY OF KAISER FOUNDATION HEALTH PLAN, INC. (KFHP-INC.), MEMBERSHIP IS AVAILABLE WITHOUT REGARD TO AGE, SEX, RACE, RELIGION, OR NATIONAL ORIGIN, OR TO THE INDIVIDUAL'S ABILITY TO PAY. HEALTH PLAN MEMBERS ARE BROADLY REPRESENTATIVE OF THE COMMUNITIES SERVED. ONCE ENROLLED, A MEMBER MAY MAINTAIN MEMBERSHIP REGARDLESS OF HEALTH OR EMPLOYMENT STATUS. AS RELATED NONPROFIT ORGANIZATIONS, KAISER FOUNDATION HEALTH PLAN, INC. AND KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST ARE COMMITTED TO IMPROVING THE HEALTH OF COMMUNITIES BEYOND ENROLLED MEMBERSHIP. ANNUAL DIRECT COMMUNITY BENEFIT INVESTMENTS (DCBI) ARE A FUNDAMENTAL EMBODIMENT OF THE ORGANIZATIONS' ONGOING COMMITMENT TO IMPROVE GENERAL WELL-BEING WITHIN THE BROADER COMMUNITY. THESE INVESTMENTS RESULT IN INTENTIONAL, PLANNED, BUDGETED, MEASURABLE, AND ACCOUNTABLE BENEFITS INTENDED TO ADDRESS MANY OF THE HEALTH CHALLENGES FACED AT THE INDIVIDUAL, LOCAL, STATE, AND NATIONAL LEVELS. IN 2007, KAISER FOUNDATION HEALTH PLAN, INC.'S BOARD OF DIRECTORS REFINED THE FOCUS OF THE ORGANIZATIONS' COMMUNITY BENEFIT PROGRAM AND ESTABLISHED THE FOLLOWING FOUR PRIORITY AREAS WHICH HAVE COME TO BE KNOWN AS "STREAMS OF WORK": - CARE AND COVERAGE FOR LOW-INCOME PEOPLE - CREATES AND SUPPORTS PROGRAMS THAT LOWER THE FINANCIAL BARRIERS FOR THE UNDER- AND UNINSURED. - 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. - 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. - DEVELOPING AND DISSEMINATING KNOWLEDGE - IMPROVES HEALTH CARE BY SHARING OUR KNOWLEDGE - EDUCATING PRACTITIONERS, ADVANCING RESEARCH, EMPOWERING CONSUMERS AND INFORMING POLICYMAKERS ABOUT EVIDENCE BASED CARE AND HEALTH. THE FOLLOWING ARE DETAILS OF COMMUNITY BENEFIT ACTIVITIES PROVIDED BY KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST IN 2013, NORTHWEST HEALTH PLAN SERVED OVER 495,000 MEMBERS AND EXPENDED $68.8 MILLION (AT COST, NET OF $33.4 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 NATIONAL STREAMS OF WORK. CARE AND COVERAGE FOR LOW-INCOME PEOPLE IN 2013, NORTHWEST HEALTH PLAN SPENT APPROXIMATELY $66.9 MILLION (AT COST, NET OF $33.4 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 KAISER PERMANENTE PROVIDER. CHARITABLE CARE (MEDICAL FINANCIAL ASSISTANCE AND CHARITABLE HEALTH COVERAGE PROGRAMS) IN OREGON AND WASHINGTON, NORTHWEST HEALTH PLAN PROVIDES CHARITY CARE TO LOW-INCOME VULNERABLE POPULATIONS THROUGH THE MEDICAL FINANCIAL ASSISTANCE AND CHARITABLE HEALTH COVERAGE PROGRAMS. IN 2013, NORTHWEST HEALTH PLAN SPENT $23.2 MILLION (AT COST, NET OF $390 THOUSAND OF RELATED REVENUES) ON UNDER- AND UNINSURED PATIENTS. A) MEDICAL FINANCIAL ASSISTANCE PROGRAM NORTHWEST HEALTH PLAN'S MEDICAL FINANCIAL ASSISTANCE (MFA) PROGRAM PROVIDES FINANCIAL ASSISTANCE FOR EMERGENCY AND MEDICALLY NECESSARY SERVICES, MEDICATIONS, AND SUPPLIES TO PATIENTS WITH A DEMONSTRATED FINANCIAL NEED. PATIENTS MUST RECEIVE HEALTH CARE SERVICES AT A KAISER PERMANENTE FACILITY AND/OR FROM A KAISER PERMANENTE PROVIDER. ELIGIBILITY IS BASED UPON PROSCRIBED LEVELS OF INCOME AND EXPENSES. IN 2013, ALMOST 13,000 QUALIFIED APPLICANTS BENEFITED FROM THIS PROGRAM, RECEIVING FULL OR PARTIAL FORGIVENESS FOR OVER 135,800 OUTPATIENT VISITS AND NEARLY 68,200 PRESCRIPTIONS. NORTHWEST HEALTH PLAN'S CHARITY CARE PROGRAM ALSO PROVIDES DISCOUNTED CHARGES FOR UNINSURED PATIENTS BELOW 400% OF FEDERAL POVERTY GUIDELINES AND CONTRACTED COLLECTION AGENCY PRACTICES ALIGNED WITH THE ORGANIZATION'S SOCIAL VALUES AND PROPOSED IRS SECTION 501(R). THE MFA PROGRAM COVERS FULL OR PARTIAL EXPENSES FOR DENTAL SERVICES IF APPLICANTS MEET QUALIFYING GUIDELINES. B) CHARITABLE HEALTH COVERAGE PROGRAM 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 POTENTIALLY COSTLY EMERGENCY ROOM VISIT OR HOSPITALIZATION. THIS ALLOWS NORTHWEST HEALTH PLAN 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. NORTHWEST HEALTH PLAN PROVIDED COVERAGE AND SERVICES VALUED AT $9.3 MILLION (AT COST, NET OF $390 THOUSAND OF RELATED REVENUES) TO PROVIDE SUBSIDIZED COVERAGE TO LOW-INCOME ADULTS AND CHILDREN WHO ARE NOT ELIGIBLE FOR STANDARD MEDICAID OR PRIVATELY FUNDED COVERAGE. THE CHARITABLE HEALTH COVERAGE PROGRAM CONSISTS OF TRANSITIONS AND THE CHILD HEALTH PLAN. - TRANSITIONS - THE TRANSITIONS PROGRAM IS A FULLY SUBSIDIZED HEALTH INSURANCE PROGRAM FOR ELIGIBLE LOW-INCOME FAMILIES. EIGHT COLLEGE CAMPUSES CURRENTLY PARTICIPATE WITHIN THE PORTLAND METROPOLITAN AREA. STUDENTS MUST BE ENROLLED IN A PARTICIPATING SCHOOL, MEET FINANCIAL CRITERION, AND CANNOT BE ENROLLED IN ANOTHER PRIVATE OR PUBLIC HEALTH CARE PLAN. GRADUATES ARE ELIGIBLE FOR AN ADDITIONAL SIX MONTHS' COVERAGE OR UNTIL EMPLOYER-PAID COVERAGE IS ACTIVATED. (NOT TO EXCEED 48 MONTHS). - CHILD HEALTH PLAN - THE CHILD HEALTH PROGRAM IS A FULLY SUBSIDIZED HEALTH INSURANCE PROGRAM FOR ELIGIBLE LOW-INCOME STUDENTS. 397 SCHOOLS CURRENTLY PARTICIPATE WITHIN THE MULTNOMAH EDUCATION SERVICE DISTRICT, SALEM-KEIZER SCHOOL DISTRICT AND HILLSBORO SCHOOL DISTRICT, BEAVERTON SCHOOL DISTRICT AND CLACKAMAS SCHOOL DISTRICT. STUDENTS MUST BE ENROLLED IN A PARTICIPATING SCHOOL, MEET FINANCIAL CRITERION, AND CANNOT BE ENROLLED IN ANOTHER PRIVATE OR PUBLIC HEALTH CARE PLAN. THE PARTICIPATING SCHOOL DISTRICTS ACT AS THE ADMINISTRATORS FOR THE PROGRAM AND ARE RESPONSIBLE FOR OUTREACH, ELIGIBILITY DETERMINATION AND ENROLLMENT. PARTICIPATION IN MEDICAID AND OTHER GOVERNMENT- SPONSORED PROGRAMS NORTHWEST HEALTH PLAN PROVIDED COVERAGE AND SERVICES VALUED AT $43.7 MILLION (AT COST, NET OF $33.0 MILLION OF RELATED REVENUES) FOR MEMBERS AND NONMEMBERS IN GOVERNMENT-SPONSORED PROGRAMS. MEDICAID PROGRAMS NORTHWEST HEALTH PLAN PARTICIPATED IN THREE MEDICAID PROGRAMS IN OREGON AND WASHINGTON. THE FOLLOWING DESCRIBE THE PROGRAMS AND TARGET POPULATIONS. A) MEDICAID MEMBER PROGRAMS - OREGON HEALTH PLAN - NORTHWEST HEALTH PLAN RECEIVES MONTHLY CAPITATED PREMIUMS FROM OREGON'S DIVISION OF MEDICAL ASSISTANCE PROGRAM (DMAP) THROUGH A PARTNERSHIP WITH HEALTH SHARE OF OREGON (HSO). MEMBERS ARE ENROLLED BASED ON ELIGIBILITY CRITERIA FOR QUALIFIED PARTICIPANTS WHO RESIDE IN CLACKAMAS, MULTNOMAH, WASHINGTON, POLK, AND MARION COUNTIES. - HEALTHY OPTIONS - HEALTHY OPTIONS IS A MEDICAID PROGRAM FOR LOW INCOME INDIVIDUALS THAT MEET ELIGIBILITY REQUIREMENTS FOR MEDICAID. IT IS A STATE PROGRAM MANAGED BY THE WASHINGTON STATE HEALTH CARE AUTHORITY (HCA). NORTHWEST HEALTH PLAN PROVIDES SERVICES TO ELIGIBLE PARTICIPANTS WHO RESIDE IN EITHER CLARK OR COWLITZ COUNTIES THROUGH A SUBCONTRACT WITH MOLINA HEALTHCARE. KFHP-NW WAS SERVING OVER 2,000 HEALTHY OPTIONS PARTICIPANTS AT THE END OF 2013. B) MEDICAID TO NONMEMBERS NORTHWEST HEALTH PLAN CONTRIBUTED $1.7 MILLION IN SUBSIDIZED CARE TO MEDICAID FEE-FOR-SERVICE PATIENTS. WHEN A MEDICAID NONMEMBER RECEIVES SERVICES FROM KAISER PERMANENTE PROVIDERS AT HOSPITALS OR OUTPATIENT SERVICES AS A RESULT OF HOSPITAL VISIT FOLLOW-UP, OR IN-PATIENT SERVICES UNDER THE MEDICAID PROGRAM, THESE EXPENSES ARE RECORDED AS NON-CAPITATED SERVICES AND ARE REPORTED AS PROFESSIONAL AND NON-PROFESSIONAL LOSSES FOR MEDICAID NONMEMBERS. C) OTHER GOVERNMENT PROGRAMS THE OREGON AND WASHINGTON MEDICAL INSURANCE POOLS PROVIDE COVERAGE TO INDIVIDUALS WHO DO NOT HAVE ACCE SAFETY NET PARTNERSHIPS THE FOLLOWING ARE THREE OF THE WAYS THAT NORTHWEST HEALTH PLAN CONTRIBUTED RESOURCES TO SUPPORT NONPROFIT SAFETY NET ORGANIZATIONS DURING 2013. 1) VOLUNTEER CLINICS - THESE EVENTS ENCOURAGE, ENGAGE, AND ASSIST KAISER PERMANENTE STAFF WHO VOLUNTEER THEIR SKILLS WITH NONPROFIT HEALTHCARE ORGANIZATIONS. A MAJOR VOLUNTEER PROGRAM HAS BECOME SYNONYMOUS WITH MARTIN LUTHER KING JR. DAY WHEN STAFF ARE ASSIGNED TO VARIOUS NONPROFIT MEDICAL CLINICS WHICH ARE TYPICALLY CLOSED FOR SERVICES ON THIS HOLIDAY. THIS PERMITS THE FACILITIES TO SERVE A GREATER NUMBER OF THE COMMUNITY WITH THEIR HEALTHCARE NEEDS. 2) DENTAL PROGRAM - THIS INITIATIVE PROVIDES SUPPORT STAFF AND FACILITIES FOR THE PROVISION OF MUCH NEEDED DENTAL CARE FOR UNDER- AND UNINSURED IN COWLITZ, LEWIS, AND WAHKIAKUM COUNTIES. PROFESSIONAL SERVICES ARE PROVIDED BY DENTAL FACULTY AND STUDENTS OF THE UNIVERSITY OF WASHINGTON DENTAL SCHOOL AND CLINICS ARE HELD APPROXIMATELY FOUR TIMES PER YEAR. 3) FREE DENTAL CARE DAYS FOR KIDS - SEVERAL OF NORTHWEST HEALTH PLAN'S DENTAL OFFICES PROVIDE FREE DENTAL CARE FOR KIDS ONE OR TWO DAYS EACH YEAR. TYPICALLY, THESE CLINICS ARE HELD ON SATURDAYS, AND CHILDREN ARE REFERRED BY SCHOOL NURSES OR OTHER COMMUNITY RESOURCES. OTHER COMMUNITY BENEFIT INVESTMENTS DURING 2013, NORTHWEST HEALTH PLAN SPENT $1.8 MILLION ON OTHER COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS BEYOND THE NATIONAL STREAMS OF WORK. THIS INCLUDES THE ADMINISTRATIVE EXPENSES OF A COMMUNITY BENEFIT DEPARTMENT DEDICATED TO SUPPORTING REGIONAL COMMUNITY BENEFIT PROGRAMS AND SERVICES AND COORDINATING RELATED INITIATIVES. ENVIRONMENTAL STEWARDSHIP POOR ENVIRONMENTAL QUALITY CONTRIBUTES TO DISEASE AND ECONOMIC INSECURITY. KAISER FOUNDATION HEALTH PLAN, INC. HAS COMMITTED ITSELF TO PROTECTING AND IMPROVING THE NATURAL ENVIRONMENT AS A KEY COMPONENT OF ITS MISSION TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES. ALTHOUGH COSTS ASSOCIATED WITH THIS INITIATIVE ARE NOT INCLUDED IN THE DOLLARS REPORTED IN DIRECT COMMUNITY BENEFIT INVESTMENTS, EFFORTS IN THIS AREA CONTRIBUTE TO ADVANCING A BROADER VISION EMPHASIZING HEALTHY PEOPLE AND HEALTHY ENVIRONMENTS. TO FULFILL THIS COMMITMENT, KAISER FOUNDATION HEALTH PLAN, INC. MAINTAINS A GOVERNANCE STRUCTURE FOR ENVIRONMENTAL STEWARDSHIP THAT ENABLES THE ORGANIZATION TO CONTINUOUSLY IMPROVE ITS PERFORMANCE. THIS STRUCTURE INCLUDES CLEARLY DEFINED ROLES, RESPONSIBILITIES, PLANS, AND ROUTINES, AND HAS RESULTED IN FIVE ORGANIZATIONAL FOCUS AREAS THAT HAVE BEEN SELECTED BASED ON THEIR ABILITY TO HAVE THE MOST IMPACT ON THE ENVIRONMENTAL FORCES THAT SHAPE ENVIRONMENTAL AND HUMAN HEALTH: - FINDING SAFE ALTERNATIVES TO HARMFUL INDUSTRIAL CHEMICALS - RESPONDING TO CLIMATE CHANGE - PROMOTING SUSTAINABLE FARMING AND FOOD CHOICES - REDUCING, REUSING, AND RECYCLING TO ELIMINATE WASTE - CONSERVING WATER IN EACH OF THESE FOCUS AREAS, KAISER FOUNDATION HEALTH PLAN, INC. HAS ESTABLISHED AMBITIOUS GOALS (INCLUDING A TARGET TO REDUCE TOTAL GREENHOUSE GAS EMISSIONS BY 30% BY 2020, COMPARED TO OUR 2008 BASELINE), IMPLEMENTED INITIATIVES, ACHIEVED MEASURABLE IMPROVEMENTS, OBTAINED EXTERNAL ASSURANCE OF PERFORMANCE, AND REGULARLY REPORTED PROGRESS TO THE BOARD OF DIRECTORS, STAFF, AND THE PUBLIC. BY REPLACING PAPER MEDICAL CHARTS AND DIGITIZING X-RAY IMAGES THROUGH THE ELECTRONIC MEDICAL RECORD SYSTEM, NORTHWEST HEALTH PLAN IS ALSO CONTRIBUTING TO THE AVOIDANCE OF APPROXIMATELY 1,000 TONS OF PAPER WASTE AND 200,000 POUNDS OF X-RAY FILM PER YEAR. DURING 2013, KEY PERFORMANCE INDICATORS FOR KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST INCLUDED: - REDUCING TOTAL GREENHOUSE GAS EMISSIONS (METRIC TONS CO2E/GROSS SQUARE FOOT) BY 5% COMPARED TO THE 2008 BASELINE FOR ALL FACILITIES AND ASSETS UNDER KFHP-NW'S OPERATIONAL CONTROL. - RECYCLING, REUSING, OR COMPOSTING APPROXIMATELY 40% OF THE WASTE GENERATED IN KFHP-NW'S FACILITIES. - INCREASING SPENDING ON "SUSTAINABLE FOOD" (AS DEFINED BY THE GREEN GUIDE TO HEALTH CARE) TO APPROXIMATELY 18% OF OVERALL SPENDING ON FOOD. - IDENTIFYING THE CHEMICALLY-SAFEST PRODUCTS IN THE FOLLOWING THREE PRODUCT CATEGORIES AND BEGINNING A TRANSITION TO THESE PRODUCTS IN ALL OF KFHP-NW'S FACILITIES: 1) ADULT MATTRESSES (THERAPEUTIC SURFACES); 2) NEONATAL MATTRESSES (THERAPEUTIC SURFACES); AND 3) SHAMPOOS, BODY WASHES, AND LOTIONS USED ON PATIENTS IN NEONATAL INTENSIVE CARE UNITS, PEDIATRIC INTENSIVE CARE UNITS, AND OTHER PEDIATRIC ENVIRONMENTS. Form 990, Part VI, Question 6 Kaiser foundation health plan, inc. is the sole member. Upon dissolution, remaining assets shall be distributed to a 501(c)(3) organization. Form 990, Part VI, Questions 7a KFHP, INC. 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-CO, OH, NW, MAS. Form 990, Part VI, Question 7b 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. Form 990, Part VI, Question 11b form 990 review process 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. The complete tax return is reviewed and signed by a Pricewaterhousecoopers LLP tax advisor. 4. The complete tax return is reviewed and signed by an officer or a member of management designated by an officer. 5. A copy of the return is provided to each board member prior to filing. Form 990, Part VI, Questions 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 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 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 notifies 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, Question 15a/b Compensation Determination: 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 & 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, Question 18 Available on Guidestar.org website Form 990, Part VI, Question 19 Public Inspection Copy: Governing documents - are available from the Department of Insurance and maintained on the state agency website or upon request. COI 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 - Tax Services 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 Organization: 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. Form 990, Part XI, Line 9 Other changes in net assets or fund balances: Change in Other Comprehensive Income $ 353,897,875 Gain/loss on sale of investments - tax (4,071,767) Gain/loss on sale of investments - book 4,962,194 Other than temporary impairment loss (6,148,014) TOTAL $ 348,640,288 Form 990, Part IX, Line 11g (col. a) Purchased Medical Service $ 356,881,741 Kaiser Permanente Oregon Plus LLC ONE KAISER PLAZA 15L OAKLAND CA 94612 202396517 HEALTH CARE OR na Kaiser Foundation Health Plan Inc ONE KAISER PLAZA 15L OAKLAND CA 94612 941340523 HEALTH CARE CA 501(c)(3) 9 NA false Kaiser Foundation Health Plan of CO Inc ONE KAISER PLAZA 15L OAKLAND CA 94612 840591617 HEALTH CARE CO 501(c)(3) 9 KFHP INC true Kaiser Foundation Health Plan of GA Inc ONE KAISER PLAZA 15L OAKLAND CA 94612 581592076 HEALTH CARE GA 501(c)(3) 9 KFHP INC true Kaiser Foundation Health Plan of the MAS ONE KAISER PLAZA 15L OAKLAND CA 94612 520954463 HEALTH CARE MD 501(c)(3) 9 KFHP INC true Kaiser Foundation Health Plan of OH Inc ONE KAISER PLAZA 15L OAKLAND CA 94612 340922268 HEALTH CARE OH 501(c)(3) 9 KFHP INC true Kaiser Foundation Hospitals ONE KAISER PLAZA 15L OAKLAND CA 94612 941105628 HEALTH CARE CA 501(c)(3) 3 KFHP INC true Camp Bowie Service Center ONE KAISER PLAZA 15L OAKLAND CA 94612 943299123 ADMIN CA 501(c)(3) 11 - I KFHP INC true Kaiser Health Alternatives ONE KAISER PLAZA 15L OAKLAND CA 94612 930954562 HEALTH CARE OR 501(c)(3) 9 KFHP INC true Kaiser Hospital Asset Management Inc ONE KAISER PLAZA 15L OAKLAND CA 94612 943299125 ASSET MGMT CA 501(c)(3) 11 - I KFH true Kaiser Health Plan Asset Management Inc ONE KAISER PLAZA 15L OAKLAND CA 94612 943299124 ASSET MGMT CA 501(c)(3) 11 - I KFHP INC true Lokahi Assurance Ltd ONE KAISER PLAZA 15L OAKLAND CA 94612 912171891 wc placement HI 501(c)(3) 11 - I KFHP INC true OHP ONE KAISER PLAZA 15L OAKLAND CA 94612 930480268 LEASING WA 501(c)(3) 11 - I KFHP INC true 1800 Harrison Foundation ONE KAISER PLAZA 15L OAKLAND CA 94612 943317484 FINANCING CA 501(c)(3) 11 - II KFHP INC true KAISER HOSPITAL ASSISTANCE CORPORATION ONE KAISER PLAZA 15L OAKLAND CA 94612 311779500 FINANCING CA 501(c)(3) 11 - III-NF KFH true HCMS LLC ONE KAISER PLAZA 15L OAKLAND CA 94607 203924985 CONSULTING CA NA N/A Archimedes Inc ONE KAISER PLAZA 15L OAKLAND CA 94612 203774729 CONSULTING CA NA C CORP true Kaiser Permanente International ONE KAISER PLAZA 15L OAKLAND CA 94612 943245176 CONSULTING CA NA C CORP true Kaiser Permanente Insurance Company ONE KAISER PLAZA 15L OAKLAND CA 94612 943203402 INSURANCE CA NA C CORP true Kaiser Properties Services Inc ONE KAISER PLAZA 15L OAKLAND CA 94612 943259432 REAL ESTATE CA NA C CORP true Oak Tree Assurance Ltd ONE KAISER PLAZA 15L OAKLAND CA 94612 030329760 INSURANCE VT NA C CORP true false false false false true false false false true false false true true false false true true true true KAISER FOUNDATION HOSPITALS I 1194326 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN INC L 15834918 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN OF COLORADO L 495801 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN OF THE MAS inc L 140044 PER AGREEMENT KAISER PERMANENTE INSURANCE COMPANY L 4059034 PER AGREEMENT LOKAHI ASSURANCE LTD L 7525718 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN INC M 94329490 PER AGREEMENT KAISER FOUNDATION HOSPITALS M 866329653 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN OF COLORADO M 493044 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN OF GEORGIA inc M 351491 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN OF THE MAS inc M 415977 PER AGREEMENT CAMP BOWIE SERVICE CENTER M 10512967 PER AGREEMENT LOKAHI ASSURANCE LTD M 20395197 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN OF OHIO M 51429 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN INC P 51176855 PER AGREEMENT KAISER FOUNDATION HOSPITALS P 1162872209 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN OF COLORADO P 253741 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN OF THE MAS inc P 76058 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN OF GEORGIA inc P 81846 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN INC R 275089555 PER AGREEMENT KAISER FOUNDATION HOSPITALS R 1368359476 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN OF OHIO R 82109 PER AGREEMENT LOKAHI ASSURANCE LTD R 28775200 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN INC S 237039696 PER AGREEMENT KAISER FOUNDATION HOSPITALS S 378866624 PER AGREEMENT LOKAHI ASSURANCE LTD S 29321600 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN OF OHIO S 84925 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN INC Q 31369663 PER AGREEMENT KAISER FOUNDATION HOSPITALS Q 358285514 PER AGREEMENT LOKAHI ASSURANCE LTD Q 13250118 PER AGREEMENT SCHEDULE R, PART II In 2013, Kaiser Foundation Health Plan, Inc. and HealthSpan Partners, an unrelated not-for-profit Ohio-based health system, entered into a definitive agreement to transfer the sole corporate membership of Kaiser Foundation Health Plan of Ohio to HealthSpan Partners. On October 1, 2013, the member substitution transaction was completed.