2014-10-20T14:25:13-05:00 2013-12-31 BDO USA LLP 3200 BRISTOL ST 4TH FLOOR COSTA MESA CA 92626 990 2013-01-01 731729007 SCAN HEALTH PLAN ARIZONA % VIRGINIA HAVAI SCAN 5629895100 3800 KILROY AIRPORT WAY Suite 100 LONG BEACH CA 908065616 CATHERINE NEMON BATTEER CEO 5629895218 2014-11-01 true WALTER H HICK JR P01070437 5629895218 2013 2015-11-30 17:44:51Z CHRISTOPHER WING 3800 KILROY AIRPORT WAY 100 LONG BEACH CA 90806 132256400 false X WWW.SCANHEALTHPLAN.COM/ARIZONA/MEDICARE/ X 2006 AZ TO SERVE AND TO IMPROVE THE LIVES OF THE FRAIL, ELDERLY RESIDENTS OF ARIZONA. 4 0 90 0 0 0 0 0 118465893 131834861 108321 105354 0 -520938 118574214 131419277 0 0 0 0 11594273 3892964 0 0 0 139828462 121507403 151422735 125400367 -32848521 6018910 64810167 35603522 92250262 57013010 -27440095 -21409488 X TO SERVE AND IMPROVE THE LIVES OF THE FRAIL, ELDERLY RESIDENTS OF ARIZONA BY PROVIDING MEDICAL AND PHARMACY SERVICES, COORDINATED CARE, SOCIAL SERVICES AND OTHER SERVICES TO A GERIATRIC POPULATION THAT IS UNDERSERVED AND AT RISK. false true 110458365 131834864 SCAN HEALTH PLAN ARIZONA, A MEDICARE ADVANTAGE CONTRACTOR, IS A NON-PROFIT MANAGED CARE ORGANIZATION THAT WAS CREATED TO SERVE THE HEALTH CARE AND INDEPENDENCE NEEDS OF THE SENIOR CITIZENS OF MARICOPA AND PIMA COUNTIES, ARIZONA. THE MISSION OF SCAN HEALTH PLAN ARIZONA IS TO FIND INNOVATIVE WAYS TO ENHANCE THE BENEFICIARIES ABILITY TO MANAGE THEIR HEALTH AND EXERT CONTROL OVER WHERE AND HOW THEY LIVE. WE WILL ACHIEVE THAT MISSION BY DEVELOPING PARTNERSHIPS THAT ALLOW US TO DELIVER THE RIGHT HEALTH CARE, IN THE RIGHT SETTING, AND AT THE RIGHT COST WHILE MAXIMIZING THE MEMBERS ABILITY TO REMAIN AS INDEPENDENT AS POSSIBLE. OUR GOAL IS TO BECOME THE LEADING GERIATRIC HEALTH MANAGEMENT ENTERPRISE IN MARICOPA AND PIMA COUNTIES. Additional Program Services Description provided in Schedule O. 110458365 false false false false false false false false false true false false false true true true 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 true true false true 1992 0 true 90 true false false false false false false false false false false X 4 0 false false true false true true false true true false false true true true true true true true true false AZ X VIRGINIA HAVAI 5629898300 3800 KILROY AIRPORT WAY LONG BEACH CA 90806 CHRISTOPHER WING DIRECTOR/CHARIMAN 3.0 37.0 X X 0 1024500 606581 DOUGLAS JAQUES GENERAL COUNSEL 3.0 37.0 X X 0 473641 180929 CATHERINE BATTEER PRESIDENT/CEO 19.0 21.0 X X 0 417933 161425 WALTER R STONE CFO 3.0 37.0 X X 0 510314 249595 RAYMOND COGEN OUTGOING MEDICAL DIRECTOR 35.0 5.0 X 208940 0 21100 DAVE FIRDAUS OUTGOING COO 35.0 5.0 X 169883 0 22226 NANCY MONK CHIEF RISK OFFICER 3.0 37.0 X 0 411753 157608 WENDY KARSTEN VP, GENERAL MANAGER 35.0 5.0 X 0 291196 75725 RICHARD PEITZMEIR VP - SALES 40.0 0.0 X 239446 0 71420 JANINE ROUMAIN OUTGOING MEDICAL DIRECTOR 35.0 5.0 X 143757 0 7471 ELIZABETH RUSSELL PRESIDENT, SOUTHWEST REGION 0.0 0.0 X 0 233860 0 762026 3363197 1554080 4 true true false HEALTHCARE PARTNERS ARIZONA LLC 19191 S VERMONT AVENUE STE 200 TORRANCE CA 90502 MEDICAL SERVICES 68114438 EXPRESS SCRIPTS INC 21653 NETWORK PLACE CHICAGO IL 606731216 MEDICAL SERVICES 21162687 SCOTTSDALE HEALTHCARE HOSPITALS PO BOX 29682 PHOENIX AZ 850389682 MEDICAL SERVICES 3206611 CATHOLIC HEALTHCARE WEST FILE 56765 LOS ANGELES CA 900746765 MEDICAL SERVICES 1773885 MEDSOLUTIONS INC 730 COOL SPRINGS BLVD SUITE 800 FRANKLIN TN 37067 MEDICAL SERVICES 1747130 91 X 0 MEDICARE PREMIUMS 900099 131834861 131834861 131834861 111342 111342 0 0 0 0 0 821000 10135 827206 9917 -6206 218 -5988 -5988 0 0 0 LOSS ON SUBSIDIARY INVESTMENT -502814 -502814 LOSS FROM WRITEOFF -18124 -18124 -520938 131419277 131834861 -415584 X 0 0 0 0 789070 789070 0 1945255 120762 1824493 280324 7761 272563 636944 27912 609032 241371 16962 224409 5199267 5199267 30446 30446 87192 87192 14000 14000 0 0 113641399 110273165 3368234 1799736 1799736 116061 4750 111311 6518 6518 0 373059 54 373005 108690 908 107782 0 12351 12351 0 0 23213 5472 17741 0 OTHER EXPENSES 95471 619 94852 125400367 110458365 14942002 0 54055661 507977 4559 29036471 0 0 4978074 3583010 0 0 0 0 0 0 0 0 122882 310474 852847 690601 172515 162246 0 1640990 5156096 0 0 0 0 0 320380 362354 64810167 35603522 41732906 6638212 0 0 288952 15710 0 0 0 0 0 0 0 0 0 0 50228404 50359088 92250262 57013010 X -27440095 -21409488 0 0 0 0 -27440095 -21409488 64810167 35603522 6018910 11697 X false true X true false 0 38649 12926 25723 0 253561 175426 78135 0 560637 1062886 58388 162246 0 DEFERRED EXECUTIVE TRUST FUNDS 293826 SURPLUS NOTE PAYABLE 50000000 DEFERRED RENT 65262 50359088 X 117206963 11697 339724 351421 116855542 14563735 14563735 131419277 111357000 28182 28182 111328818 14071549 14071549 125400367 FORM 990 - SCHEDULE D - PART X, LINE 2 Under FASB ASC 740, Income taxes, the Company is required to recognize a liability for each uncertain tax position at the amount estimated to be required to settle the issues. As of December 31, 2013 and 2012, there were no liabilities recorded for uncertain tax positions. FORM 990 - SCHEDULE D - RECONCILIATION OF REVENUE - PART XI The organization's separate financial statements were prepared on a statutory basis in conformity with the manual and accounting practices prescribed and permitted by the DOI (NAIC SAP). The following adjustments were required: Line 2d - Additional revenue recognized on the financial statements of $339,724; $300,000 statutory audit adjustmet for reversal of prior year risk adjustment; $28,177 represents a reclassification for stop loss reinsurance which was classified as revenue on the financial statements and an expense on Form 990; $11,547 adjustment for bonds difference in market value vs amortized cost. Line 4b - Additional revenue recognized on the form 990 of $14,563,735; $15,066,599 of Premium Deficiency Reserve (PDR) Revenue classified as revenue on the form 990 and as an expense on the financial statements, the adjustment nets to zero with the adjustment in Part XII line 4b; <$502,814> of loss from a subsidiary investment not reported on the financial statements. FORM 990 - SCHEDULE D - RECONCILIATION OF EXPENSES - PART XII The organization's separate financial statements were prepared on a statutory basis in conformity with the manual and accounting practices prescribed and permitted by the DOI (NAIC SAP). The following adjustments were required: Line 2d - Additional expenses recognized on form 990 of $28,182 represents a reclassification of expenses which were classified as revenue on the financial statements. Line 4b - Additional expenses on the financial statements of $14,071,549; $15,066,599 of Premium Deficiency Reserve (PDR) Revenue classified as an expense on the financial statement and as revenue on form 990, the adjustment nets to zero with the adjustment in Part XI line 4b; <$995,000> represents statutory audit adjustment to reverse a prior year adjustment relating to the IBNR over reserve. X true true true true false false false false false false false CHRISTOPHER WING DIRECTOR/CHARIMAN 0 596228 0 407160 0 21112 0 582294 0 24287 0 1631081 0 0 DOUGLAS JAQUES GENERAL COUNSEL 0 315305 0 96531 0 61805 0 127877 0 53052 0 654570 0 0 CATHERINE BATTEER PRESIDENT/CEO 0 303943 0 92832 0 21158 0 161425 0 0 0 579358 0 0 WALTER R STONE CFO 0 379039 0 108244 0 23031 0 198733 0 50862 0 759909 0 0 NANCY MONK CHIEF RISK OFFICER 0 284032 0 108755 0 18966 0 138201 0 19407 0 569361 0 0 WENDY KARSTEN VP, GENERAL MANAGER 0 212256 0 25173 0 53767 0 55858 0 19867 0 366921 0 0 RICHARD PEITZMEIR VP - SALES 182174 0 37002 0 20270 0 59597 0 11823 0 310866 0 0 0 RAYMOND COGEN OUTGOING MEDICAL DIRECTOR 81953 0 55003 0 71984 0 13115 0 7985 0 230040 0 0 0 DAVE FIRDAUS OUTGOING COO 91530 0 50003 0 28350 0 11440 0 10786 0 192109 0 0 0 JANINE ROUMAIN OUTGOING MEDICAL DIRECTOR 89004 0 27841 0 26912 0 0 0 7471 0 151228 0 0 0 ELIZABETH RUSSELL PRESIDENT, SOUTHWEST REGION 0 0 0 0 0 233860 0 0 0 0 0 233860 0 216360 FORM 990 - SCHEDULE J - PART I, LINE 1A Significant others of certain SCAN Group, SCAN Health Plan and SCAN Arizona executives attended a Company business event in 2013, at the Companys request, for the business purpose of creating deeper and more productive relationships between SCAN and important SCAN third party business partners. Since the Company requested that the SCAN significant others attend for the purpose of achieving a Company business objective, the Company reimbursed the travel expenses of those companions. Additionally, members of the Board of Directors of SCAN GROUP, SCAN HEALTH PLAN, AND SCAN HEALTH PLAN ARIZONA, AND THEIR COMPANIONS, ATTENDED AN OFFSITE BOARD MEETING IN 2013 WHICH WAS PAID FOR BY SCAN HEALTH PLAN. FORM 990 - SCHEDULE J - PART I, LINE 3 Compensation for the President was established and paid by a related organization. The related organization used the following to establish the Presidents compensation: (1) Compensation committee; (2) independent compensation consultant; (3) Form 990 of other organizations; (4) written employment contract; (5) compensation survey or study; (6) approval by the chair of compensation committee. FORM 990 - SCHEDULE J - PART I, LINE 4A During 2013, the employment relationship of the following Highest Compensated Employee with SCAN Health Plan Arizona was ended. In connection with the termination of employment, SCAN Health Plan Arizona negotiated and paid severance. The severance payment was in accordance with the terms of their then existing employment agreement. Janine Roumain, Outgoing AZ Medical Director, Highly Compensated Employee - SCAN Health Plan Arizona, $4,615 FORM 990 - SCHEDULE J - PART I, LINE 4B The Company provides a supplemental non-qualified retirement plan; only senior executives of the Company, Senior V.P.s and officers are eligible to participate in the section 457(f) plan. Pursuant to the terms and conditions of the section 457(f) plan, a participant becomes 100% vested in the employer contribution upon the occurrence of any of the following while the participant is an employee; (I) the participant has ten years of continuous employment, counting only service after December 31, 2005 (II) the participant reaches the age of 62 and has five years of continuous employment; (III) the participant's involuntary termination; (IV) the participant's disability; or (V) the participant's death. Elizabeth Russell, the former President southwest region, participated in the 457(f) plan until her employment ended on 12/31/2012, she received 457(f) distributions of $216,360 in 2013. FORM 990 - PROGRAM SERVICE ACCOMPLISHMENTS - PART III, LINE 3 For the current year, 2013, there is a decrease in the program services expensed by SCAN Health Plan Arizona. Effective, January 1, 2013, SCAN Health Plan Arizona entered into an agreement with Healthcare Partners Affiliates Medical Group ("HCP"), a California professional partnership for the provision of physician group services and certain third party administrative services. As a result, HCP now performs the services of processing all claims from the member's provider with exception of pharmacy claims and HCP assumed responsibility for patient management. SCAN Health Plan Arizona continues to manage the enrollment of new members and the reenrollment of existing members, process member billings and manage the member's receivables. For services rendered by HCP, SCAN Health Plan Arizona compensates HCP based on mutually agreed upon rates. FORM 990 - PROGRAM SERVICE ACCOMPLISHMENTS - PART III, LINE 4A SCAN Health Plan Arizona began program operations as a Medicare Advantage contractor effective January 1, 2007. It is responsible for arranging and monitoring the full range of Medicare health services for plan enrollees. The plan began offering a Medicare advantage special needs plan (SNP) for beneficiaries who are dually eligible and enrolled in both the Medicare and ALTCS programs. Beginning January 1, 2009, the Plan expanded its Medicare advantage participation to other Medicare beneficiary populations, through a Medicare advantage prescription drug (MAPD) plan. In January 2008 SCAN launched the SCAN Connections community resource center designed to link SCAN members, their caregivers and others in the Maricopa county communities with knowledgeable staff who can assist in navigating a complex health care system. The resource center staff build bridges into other community organizations, governmental agencies and health advocacy groups to provide to the community health education and support services focused on geriatric, chronic illness and physically disabled challenges. Services and resources are provided at the SCAN Connections resource center in SCAN's office and at remote community sites. SCAN Health Plan Arizona has grown from no membership at December 31, 2006 and currently serves more than 12,932 enrollees. The addition of the SCAN Classic and SCAN Connections programs allow SCAN personnel, especially the case management team, to more effectively coordinate the needed health care services required by SCAN members. From the start of operations, the Arizona companies have devoted nearly 98% of their revenue to the direct provision of health care, home and community based services and long term care residential services. This represents more than $1,037 million of direct care services for these Medicare and Medicaid enrollees. Of the total amount paid for medical and residential services, approximately 26.5% was directed to long term care residential service providers, 17.0% was directed to home and community based service providers, and 54.5% was directed to other medical service providers and the remaining 2.1% was directed to case management coordination services. FORM 990 - GOVERNANCE, MGMT & DISCLOSURE - PART VI, SECTION A, LINE 4 The organization amended and restated bylaws which were adopted by the Board of Directors and became effective on January 1, 2013. Changes to the organization's bylaws are as follows: Article 1: The sole member of the Corporation shall be SCAN Group (the "Corporate Member") The Corporate Member reserves a specific set of powers, thereby requiring the Corporation to seek prior approval for decisions within the scope of those powers. Key examples of these reserved powers include 1) the decision to borrow money; 2) the decision to enter into or amend any contractual arrangement that is not within the scope of the annual budget or operating plan previously approved by the Board of Directors (exclusive of provider services agreements) where payments by the Corporation are expected to exceed $2MM; 3) the decision to expand the service area of the Corporation, etc. A complete list of the decisions requiring prior approval is available upon request. Article 2, Section 2: Changes the number of Directors. FORM 990 - GOVERNANCE, MGMT & DISCLOSURE - PART VI, SECTION A, LINE 6 The Sole Member of the organization is SCAN Group, A California Nonprofit Corporation. FORM 990 - GOVERNANCE, MGMT & DISCLOSURE - PART VI, SECTION A, LINE 7A The sole member has the power to appoint the members of the Board of Directors. FORM 990 - POLICIES - PART VI, SECTION B, LINE 11B The Form 990 is prepared by BDO USA, LLP, working in conjunction with SCAN's finance department. SCAN Health Plan's Director of accounting has direct responsibility for this effort, subject to supervision by the SCAN Health Plan Controller. After an initial draft of the Form 990 is prepared, it is circulated for review and comment by relevant members of the executive team who have responsibility and/or knowledge about the various matters disclosed and/or described in the Form. The General Counsel, in particular, reviews the Form 990 and ensures accuracy of descriptions and that disclosure is complete. The draft Form 990 is reviewed by the Audit and Compliance Committee in addition to the compensation committee of the Board of Directors of SCAN Group, and is shared with all members of the Board of Directors after it is ready for filing but before it is filed. FORM 990 - POLICIES - PART VI, SECTION B, LINE 12C SCAN Health Plan Arizona regularly and consistently monitors and enforces compliance with its conflict of interest policy through annual circulation of a conflict of interest questionnaire which is required to be answered by all members of the Board of Directors, officers and members of executive management. In addition, there is regular education and enforcement through oversight of such policy and the SCAN Health Plan Arizona Gift and Business Courtesies Policy with respect to each department by members of the senior executive team with responsibility for such department. The Legal Department of SCAN Group reviews all contractual relationships entered into by the organization and the General Counsel of SCAN Group is responsible for monitoring conflicts of interest through the annual circulation and review of the conflict of interest questionnaire. Accordingly, the Legal Department of SCAN Group through the General Counsel is in a position to monitor and enforce compliance with the policy on an ongoing basis. FORM 990 - POLICIES - PART VI, SECTION B, LINE 15A The process for determining the compensation of the President of SCAN Health Plan Arizona is conducted by the Compensation Committee of the Board of Directors of SCAN Group, all of the voting members of which are independent persons. In determining the President's compensation, the Compensation Committee works with and relies upon the counsel and expertise of Ernst & Young, a consultant with well-established experience and expertise in the area of nonprofit organization executive compensation and compliance with the intermediate sanctions requirements applicable to such compensation. Ernst & Young provides an "Executive Compensation Report" to the Compensation Committee each year which furnishes the basis for the establishment of the President's compensation package during the following year. The Ernst & Young Executive Compensation Report is based on a review of the executive compensation practices of a variety of organizations that are considered comparable to SCAN Health Plan Arizona based on various metrics. The Compensation Committee deliberates on the issue of the President's compensation package in light of the Ernst & Young Executive Compensation Report and questions are asked of, and answered by Ernst & Young, regarding such report and other matters relevant to such package. Based on such deliberations, the Compensation Committee makes a recommendation to the Board of Directors of SCAN Health Plan Arizona regarding the compensation package for the following year. The Board of Directors of SCAN Health Plan Arizona deliberates on and then votes on such recommendation; the President is recused for the entirety of such deliberations and vote. The minutes of the Compensation committee for these meetings are prepared substantially contemporaneously and substantiate such deliberations and decisions. FORM 990 - POLICIES - PART VI, SECTION B, LINE 15B The process for determining the compensation of officers or other key employees of SCAN Health Plan Arizona is conducted by the Human Resources Department and CEO. In determining such employee's compensation, the Human Resources Department works with and relies upon the counsel and expertise of Ernst & Young, a consultant with well-established experience and expertise in the area of nonprofit organization executive compensation and compliance with the intermediate sanctions requirements applicable to such compensation. Ernst & Young provides an "Executive Compensation Report" to the Human Resources Department each year which furnishes the basis for the establishment of such employees' compensation package during the following year. The Ernst & Young Executive Compensation Report is based on a review of the executive compensation practices of a variety of organizations that are considered comparable to SCAN Health Plan Arizona based on various metrics. FORM 990 - DISCLOSURE - PART VI, SECTION C, LINE 19 SCAN Health Plan Arizona's governing documents and conflict of interest policy are not made available to the public. SCAN Health Plan Arizona's audited financial statements are publicly available from the Arizona Department of Insurance for a nominal fee. FORM 990 - FINANCIAL STATEMENTS AND REPORTING - PART XII, LINE 2C SCAN Health Plan Arizona changed its independent accountant to BDO USA, LLP in 2013. FORM 990 PART IX LINE 11G DESCRIPTION:OTHER EXPENSES TOTAL FEES:487363 FORM 990 PART IX LINE 11G DESCRIPTION:BROKERS COMMISSION TOTAL FEES:2916565 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL EXPENSES FOR ELDERLY TOTAL FEES:XXX-XX-XXXX SCAN GROUP 3800 KILROY AIRPORT WAY LONG BEACH CA 90806 953826037 ADMIN SUPPORT CA 501(C)(3) 11, TYPE II NA false SCAN HEALTH PLAN 3800 KILROY AIRPORT WAY LONG BEACH CA 90806 953858259 MEDICARE ADVA CA 501(C)(3) 9 SCAN GROUP true SCAN LONG TERM CARE 3800 KILROY AIRPORT WAY LONG BEACH CA 90806 204607594 MEDICARE MGT. AZ 501(C)(4) N/A SCAN HP AZ true THE SCAN FOUNDATION 3800 KILROY AIRPORT WAY LONG BEACH CA 90806 450552845 GRANT MAKING CA 501(C)(3) 11, TYPE II SCAN GROUP true SCAN 360 CARE 3800 KILROY AIRPORT WAY LONG BEACH CA 90806 352443412 MEDICARE SVCS CA 501(C)(3) 9 SCAN GROUP true SCAN MANGAGEMENT SERVICES COMPANY 3800 KILROY AIRPORT WAY LONG BEACK CA 90806 900860955 MANAGEMENT CA SCAN GROUP C CORPORATION false SCAN WELLNESS CENTER PC 3800 KILROY AIRPORT WAY LONG BEACH CA 90806 900860971 HEALTHCARE CA SCAN GROUP C CORPORATION false SCAN HEALTH CHECK ASSESSMENT CENTERS 3800 KILROY AIRPORT WAY LONG BEACH CA 90806 462962358 HEALTHCARE CA SCAN GROUP C COPRORATION false SCAN CALIFORNIA MANAGEMENT COMPANY 3800 KILROY AIRPORT WAY LONG BEACH CA 90806 462951831 MANAGEMENT CA SCAN GROUP C CORPORATION false false false false false false false false false false false false false false false false true false false true SCAN HEALTH PLAN P 3459270 Actual expense SCAN GROUP P 1739997 Actual expense SCAN LONG TERM CARE S 2997186 Capital return FORM 990 - TRANSACTIONS WITH RELATED ORGANIZATIONS - SCHEDULE R, PART V The percentage of allocation to affiliated companies is determined based on estimated percentage of time worked, percentage of headcounts, and the percentage of SCAN membership, as appropriate based on the nature of the expense.