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HealthSpan Integrated Care: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
HealthSpan Integrated Care (EIN 34-0922268)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-12
IRS object ID
201303169349304480
Schema version
2012v2.1
Note
A later return for the same period supersedes this one.
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-12T13:31:23-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PRICEWATERHOUSECOOPERSBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12001 MARKET ST SUITE 1700AddressLine1
CityPHILADELPHIACity
StatePAState
ZIP Code19103ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN340922268EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1KAISER FOUNDATION HEALTH PLAN OF OHIOBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% VP - NATIONAL TAX COMPLIANCEInCareOfName
Name ControlKAISNameControl
Phone5102716611Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE KAISER PLAZA 15LAddressLine1
Address Line2SuiteAddressLine2
CityOAKLANDCity
StateCAState
ZIP Code94612ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDEBORAH STOKESName
TitleSVP, CC & CAOTitle
Date Signed2013-11-06DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone2673303000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonPATRICIA KENNEDY-SCOTTNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1ONE KAISER PLAZA 15LAddressLine1
CityOAKLANDCity
StateCAState
ZIP Code94612ZIPCode
FieldValueIRS element (for citing)
Gross Receipts588732916GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1978YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees1785TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI53371TotalGrossUBI
Net Unrelated Business Txbl Income13962NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year45581ContributionsGrantsPriorYear
Contributions Grants Current Year12000ContributionsGrantsCurrentYear
Program Service Revenue Prior Year558821465ProgramServiceRevenuePriorYear
Program Service Revenue CY520792175ProgramServiceRevenueCY
Investment Income Prior Year2840498InvestmentIncomePriorYear
Investment Income Current Year3413678InvestmentIncomeCurrentYear
Other Revenue Prior Year157813OtherRevenuePriorYear
Other Revenue Current Year108998OtherRevenueCurrentYear
Total Revenue Prior Year561865357TotalRevenuePriorYear
Total Revenue Current Year524326851TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1976805GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY770156GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year151645515SalariesEtcPriorYear
Salaries Etc Current Year153849150SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year455827817OtherExpensePriorYear
Other Expenses Current Year430063743OtherExpensesCurrentYear
Total Expenses Prior Year609450137TotalExpensesPriorYear
Total Expenses Current Year584683049TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-47584780RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-60356198RevenuesLessExpensesCY
Total Assets BOY271986191TotalAssetsBOY
Total Assets EOY334654842TotalAssetsEOY
Total Liabilities BOY446139061TotalLiabilitiesBOY
Total Liabilities EOY560428826TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-174152870NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-225773984NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense515009014Expense
Grants87868Grants
Revenue520518163Revenue
Descriptionmember 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

Activity2 Activity2

FieldValueIRS element (for citing)
Expense10089523Expense
Grants0Grants
Revenue274012Revenue
DescriptionCharitable Care (Medical Financial Assistance and Charitable Coverage) Ohio Health Plan provides charity care to low-income vulnerable patients through the Medical Financial Assistance (MFA) and Charitable Health Coverage (CHC) Programs. Ohio Health Plan offers financial assistance through our MFA program to help families and individuals that are unable to pay for all or part of the cost of urgent or emergent care provided in Kaiser Permanente facilities. In 2012, this program assisted more than 3,300 qualifying applicants, providing over 24,000 outpatient office visits. The CHC program is available to low income families who are not eligible for other public or privately sponsored coverage. Approximately 1,300 individuals were receiving comprehensive care through this program at the end of 2012. Additional information about Ohio Health Plan's charitable activities can be found in Schedule O, Community Benefit Summary Report.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense682288Expense
Grants682288Grants
Revenue0Revenue
DescriptionGrants 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

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense1028156Expense
Grants0Grants
Revenue0Revenue
DescriptionSCH. O, COMMUNITY BENEFIT SUMMARY REPORTDescription
FieldValueIRS element (for citing)
Total Of Other Program Service Exp1028156TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense526808981TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10961909NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1785NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocstrueChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledOHStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest
Other Explain In Sch OXOtherExplainInSchO

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonVP - NATIONAL TAX COMPLIANCENamePerson
Telephone Number5102716385TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ONE KAISER PLAZA 15LAddressLine1
CityOAKLANDCity
StateCAState
ZIP Code94612ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (37 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Christine Cassel
Director0.510.5X02035000
Thomas Chapman
Director2.011.0X021410817000
Daniel Garcia
SVP, Chief Compliance Officer2.048.0X0142427283764
William Graber
Director1.06.5X02408230
J Eugene Grigsby III
Director0.58.0X02210000
George Halvorson
Chairman and CEO5.045.0X0980035186158X
Judith Johansen
Director0.36.0X02071460
Kim J Kaiser
Director0.58.0X02285000
Philip Marineau
Director0.586.34X02256180
Jenny Ming
Director0.24.9X02143230
Edward Pei
Director0.57.5X020664117000
Margaret E Porfido
Director0.59.0X02377790
J Neal Purcell
Director0.58.5X02514640
Cynthia Telles
Director0.56.6X02267170
Bernard J Tyson
President & COO5.045.0X04087093624945X
Patricia Kennedy-Scott
Region President - Ohio45.05.00790401167810X
Kathryn Lancaster
EVP & CFO4.046.002779989332894X
Donna Lynne
Group President6.044.001109779224081X
Thomas Meier
SVP, Corporate Treasurer3.047.00816082129748X
Donald Orndoff
SVP, NFS5.045.00766341160171X
ROCHELLE ROTH
Exec Dir, Health Plan QCSO7.043.0024504447186X
Arthur Southam
EVP, Health Plan Operations5.045.003350376379989X
Deborah Stokes
SVP, CC & CAO4.046.00690493143269X
Victoria Zatkin
VP, Off of Brd & Corp Gov Svcs4.046.0033927186546X
Mark Zemelman
SVP, Gen Counsel & Secretary2.048.001019066229497X
Craig M Faerber
VP, CFO - Ohio50.00.0048278282130X
Pamela Hara
VP, Quality/Service50.00.00324345101778X
Carolyn Hightower
VP, Regional HP Admin - OH50.00.0033758588892X
Joseph M LaGuardia
VP, Mktg, Sls & Bus Devel50.00.0024180466535X
Belva Tibbs
VP, Medical Operations50.00.0034066689833X
Timothy Alberts
VP, Human Resources50.00.0033017989105X
Heather Bossin
Dir, Financial Services50.00.0018571466851X
Fred S Lefton
Dir, Asst Pharmacy Operation50.00.0015314355883X
Nancy Ellen Paton
Exec Dir, Public Affairs50.00.0019201536255X
Jeffrey Wallace
Dir, Pharmacies50.00.0016871568271X
Steven Zatkin
Former Gen. Counsel/Consultant0.00.0032350181586X
Thomas Revis
Former VP, CFO - Ohio0.00.0023312860569X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs33209754TotalReportableCompFrmRltdOrgs
Total Other Compensation3617746TotalOtherCompensation
Number Individuals GT100 K99NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
CAMPBELL-EWALD
PO Box 7247-7821PHILADELPHIAPA19170Advertising4439682
THE CLEVELAND CLINIC
9500 EUCLID AVECLEVELANDOH44195HOSPITAL SERVICES13401795
OHIO PERMANENTE MEDICAL GROUP
1001 LAKESIDE AVECLEVELANDOH44114MEDICAL SERVICES84516029
THE METROHEALTH SYSTEM
2500 METROHEALTH DRIVECLEVELANDOH44109HOSPITAL SERVICES6752635
KAISER FOUNDATION HOSPITALS
1001 LAKESIDE AVECLEVELANDOH44114HOSPITAL SERVICES52266162
FieldValueIRS element (for citing)
Number Of Contractors GT100 K242NumberOfContractorsGT100K
Related Organizations12000RelatedOrganizations
Total Contributions12000TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
MBRS HLTH CARE PRM621400381341427381341427
MEDICARE621400111062391111062391
SUPP CHARGES/PHARM6214002543210525432105
NON-PLAN & IND REV6214001300789124741853371
OTHER PROGRAM SERVICE62140016554631655463
FieldValueIRS element (for citing)
Total Program Service Revenue520792175TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2406616TotalRevenueColumn
Exclusion$2,406,616ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real108998Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real108998Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column108998TotalRevenueColumn
Exclusion$108,998ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities65409077Securities
Other4050Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities64406065Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1003012Securities
Other4050Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1007062TotalRevenueColumn
Exclusion$1,007,062ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column524326851TotalRevenueColumn
Related Or Exempt Function Income520738804RelatedOrExemptFunctionIncome
Unrelated Business Revenue53371UnrelatedBusinessRevenue
Exclusion$3,522,676ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total770156Total
Program Services770156ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total99317162Total
Program Services87584875ProgramServices
Management And General11732287ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total18166371Total
Program Services16272269ProgramServices
Management And General1894102ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total29235260Total
Program Services28665693ProgramServices
Management And General569567ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total7130357Total
Program Services3023560ProgramServices
Management And General4106797ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total46510Total
Management And General46510ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total1083279Total
Management And General1083279ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total80570Total
Management And General80570ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total82218Total
Management And General82218ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total98921605Total
Program Services90409655ProgramServices
Management And General8511950ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total5739125Total
Program Services71893ProgramServices
Management And General5667232ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1408479Total
Program Services1072163ProgramServices
Management And General336316ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total39505795Total
Program Services30320310ProgramServices
Management And General9185485ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total5870509Total
Program Services5870509ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total951327Total
Program Services588036ProgramServices
Management And General363291ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total255553Total
Management And General255553ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total9401062Total
Program Services9401062ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total6688344Total
Program Services6688344ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total5292471Total
Program Services5292471ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
CONTRACTUAL PAYMENTS136781191136781191
SUPPLIES68415489591264219289068
INTER-REGIONAL CHARGES21653640201568881496752
PREMIUM DEFICIENCY RESERVES1210000012100000

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total15786576Total
Program Services12613485ProgramServices
Management And General3173091ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total584683049Total
Program Services526808981ProgramServices
Management And General57874068ManagementAndGeneral
Fundraising0Fundraising
FieldValueIRS element (for citing)
Info In Schedule O Part XXInfoInScheduleOPartX

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY21586402BOY
EOY21382567EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY15274008BOY
EOY11987483EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY5657326BOY
EOY6245064EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY662853BOY
EOY568345EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis182523766LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec121160330LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY64530378BOY
EOY61363436EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY136979074BOY
EOY213301628EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY27296150BOY
EOY19806319EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY271986191BOY
EOY334654842EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY53747797BOY
EOY46912077EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY8488470BOY
EOY8331743EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY383902794BOY
EOY505185006EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY446139061BOY
EOY560428826EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY4886800BOY
EOY4886800EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY-179039670BOY
EOY-230660784EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-174152870BOY
EOY-225773984EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY271986191BOY
EOY334654842EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-60356198ReconcilationRevenueExpenses
Reconciliation Unrealized Invest510823ReconciliationUnrealizedInvest
Reconcilation Donated Services0ReconcilationDonatedServices
Reconcilation Prior Adjustment0ReconcilationPriorAdjustment
Reconcilation Other Changes8224261ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement BothXFinancialStatementBoth
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years164696CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years80601CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years262333CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year45581CurrentTaxYearMinus1Year
Current Tax Year12000CurrentTaxYear
Total565211Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years592918588CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years595429126CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years587211818CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year558821465CurrentTaxYearMinus1Year
Current Tax Year520738804CurrentTaxYear
Total2855119801Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years593083284CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years595509727CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years587474151CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year558867046CurrentTaxYearMinus1Year
Current Tax Year520750804CurrentTaxYear
Total2855685012Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total5092855685012PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5406147CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4393255CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2079211CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2548931CurrentTaxYearMinus1Year
Current Tax Year2515614CurrentTaxYear
Total16943158Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Current Tax Year11220CurrentTaxYear
Total11220Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5406147CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4393255CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2079211CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2548931CurrentTaxYearMinus1Year
Current Tax Year2526834CurrentTaxYear
Total16954378Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Total0Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Total0Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years598489431CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years599902982CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years589553362CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year561415977CurrentTaxYearMinus1Year
Current Tax Year523277638CurrentTaxYear
Total2872639390Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99410PublicSupportPercentage509
Prior Year Support Percentage0.99299PriorYearSupportPercentage
Investment Income Percentage0.00590InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00701PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementtruePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationstrueGrantsOtherOrganizations
Grants Other Organizations$25,000GrantsOtherOrganizationsAmount
Direct Contact LegislatorstrueDirectContactLegislators
Direct Contact Legislators$24,698DirectContactLegislatorsAmount
Rallies DemonstrationstrueRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$30,872OtherActivitiesAmount
Total Lobbying Expenditures IIB80570TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV (2 entries)

IdentifierIdentifierExplanationExplanation
Schedule C, Part II-B, Line 1A - 1ILOBBYING 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.
Schedule C, Part I-B, Line 3 & 4In 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.

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years
Current Year Minus4 YearsCurrentYearMinus4Years

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis5961963OtherCostOrOtherBasis
Book Value5961963BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis92830877OtherCostOrOtherBasis
Depreciation49915496Depreciation
Book Value42915381BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis10006060OtherCostOrOtherBasis
Depreciation4221801Depreciation
Book Value5784259BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis44964996OtherCostOrOtherBasis
Depreciation39751662Depreciation
Book Value5213334BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis28759870OtherCostOrOtherBasis
Depreciation27271371Depreciation
Book Value1488499BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings61363436TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
OTHER CURRENT ASSETS131708
DUE FROM AFFILIATED ORG.19274611
STATUTORY DEPOSITS400000
FieldValueIRS element (for citing)
Total Book Value Other Assets19806319TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (9 entries)

DescriptionDescriptionAmountAmount
DUE TO AFFILIATED ORGANIZATION$26,636,220
RESERVE FOR PROF & PUBLIC LIAB$24,648,611
RESERVE FOR WORKERS COMP RISK$3,053,630
SELF INSURED - AUTO & UNEMPLOY$100,305
MEDICARE LIABILITY RESERVE$22,581,292
PREMIUM DEFICIENCY RESERVE$26,900,000
SUBORDINATED LIABILITIES$221,791,986
POST RETIREMENT BENEFITS$177,929,055
OTHER LIABILITIES$1,543,907
FieldValueIRS element (for citing)
Total Of Amounts505185006TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt522388215TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments510823NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities0DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants0RecoveriesOfPriorYearGrants
Other Revenues1001808OtherRevenues
Revenue Not Rptd F9901512631RevenueNotRptdF990
Revenue Subtotal520875584RevenueSubtotal
Other Revenues Not Included3451267OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt3451267RevenueNotRptdOnFinStmt
Total Revenue Per Form990524326851TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt590295823TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities0DonatedServicesUseOfFacilities
Prior Year Adjustments0PriorYearAdjustments
Losses Reported0LossesReported
Other Expenses Included8143247OtherExpensesIncluded
Expenses Not Rptd F9908143247ExpensesNotRptdF990
Expenses Subtotal582152576ExpensesSubtotal
Investment Expenses Not Included282218InvestmentExpensesNotIncluded2
Other Expenses Not Included2448255OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt2530473ExpensesNotRptdOnFinStmt
Total Expenses Per Form990584683049TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Schedule D, Part X, Line 2FIN 48 FootnoteThe organization financial statements do not include a footnote under FIN 48.
Schedule D, Part XIReconciliation of RevenueLine 2d: Gain/Loss on Investments - Book 1,205,220 Investment Management Expenses ( 82,218) OTTI Losses - See "note 1" ( 121,194) _________________ TOTAL $ 1,001,808 Note 1: other than temporary impairment (OTTI) of investment recognized for financial statement purposes, which will be tax reported when realized. Line 4b: Other Revenue - Reclass 337,557 Bad debt expense - Reclass 2,110,698 Gain(Loss) on Investments - Tax 1,003,012 _____________ TOTAL $ 3,451,267
Schedule D, Part XIIReconciliation of ExpensesLine 2d: Change in Other Comprehensive Income $ 8,143,247 Line 4b: Bad Debt Expenses - Reclass 2,110,698 Misc Expense - Reclass 337,557 ___________________ TOTAL $ 2,448,255

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (24 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrantAddress Line2AddressUS/AddressLine2
American Heart Association Inc
1689 East 115th StClevelandOH44106135613797501(c)(3)7470KP Care Fund
Boys and Girls Clubs of Cleveland
6114 Broadway AveClevelandOH44127340770686501(c)(3)9900Race for Kids & Well
Case Western Reserve University
10900 Euclid AveClevelandOH44106341018992501(c)(3)35000HEAL Evaluation
Celebrate Westlake
36097 WestminsterN RidgevilleOH44039341703289501(c)(3)100002012 Eagle Run
Cleveland Board of Education
1380 East Sixth StClevelandOH44114346000662Government19680Army of Believers
Cleveland Foodbank Inc
15500 S Waterloo RoadClevelandOH44110341292848501(c)(3)15500KP Community Care Fd
Cleveland Hearing and Speech Center
11635 Euclid AveClevelandOH44106340714648501(c)(3)15000Regional Infant Hear
Cleveland Rape Crisis Center
526 Superior Ave1400ClevelandOH44114510164315501(c)(3)5900Sing Out!, Event
Cleveland State University Foundation Inc
2121 Euclid Ave MM105ClevelandOH44115341316665501(c)(3)218343Careers Health/Med/WellnessUniv Circle
Cuyahoga Community College Foundation
700 Carnegie AveClevelandOH44115237320719501(c)(3)22700Bridgeport Food Des;Presidential Scholarship Lunch
Cuyahoga Health Access Partnership
75 Erieview PlazaClevelandOH44114271217221501(c)(3)25000Support Cuyahoga
Cuyahoga Valley Countryside Conservancy
2179 Everett RoadPeninsulaOH44264341896395501(c)(3)25000Operating Support
Free Medical Clinic of Greater Cleveland
12201 Euclid AveClevelandOH44106237078501501(c)(3)16976Care and Prevention
Greater Cleveland Community Shares
3631 Perkins AveClevelandOH44114341493880501(c)(3)6800KP Community Care Fd
Legal Aid Society of Cleveland
1223 West Sixth StClevelandOH44113340866026501(c)(3)25000Community Advocacy
Near West Side Multi Service Corporation
4115 Bridge AveClevelandOH44113237061949501(c)(3)25000May Dugan Cnter Hlth
North Coast Health Ministry
16110 Detroit AveLakewoodOH44107341536257501(c)(3)40380Operating Support
Northeast Ohio Neighborhood
4800 Payna AveClevelandOH44103341014291501(c)(3)6798Golf Outing Spons'p
St Martin De Porres High School Work Study
6111 Lausche AveClevelandOH44103300204919501(c)(3)16384Corporate Work Study
The Living Miracles Peer Empowerment Center
11801 Clifton Blvd 2LakewoodOH44107611601980501(c)(3)7500Wellness Management
United Negro College Fund - Dec 12 Accrual
2000 Auburn Drsite 200ClevelandOH44122131624241501(c)(3)15000CB Contribution
United States Conference Catholic Bishops
1228 Euclid Ave 330ClevelandOH44115530196617501(c)(3)10000OH Reg Convergence
United Way of Greater Cleveland
1331 Euclid AveClevelandOH44115346516654501(c)(3)25851KP Communi Care Fund
YMCA of Cleveland Ohio Inc
2200 Prospect Ave 900ClevelandOH44115340714728501(c)(3)50000We RunThisCity Youth
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants24TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierSchedule I, Part I, Question 2Identifier
ExplanationGrantees 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

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (37 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Timothy Alberts
VP, Human Resources0197973098778033428071166017939041928400
Heather Bossin
Dir, Financial Services017119601000004518045243021608025256500
Christine Cassel
Director020350000000000020350000
Thomas Chapman
Director0214108000001700000023110800
Craig M Faerber
VP, CFO - Ohio03469720345130101297062691019439056491200
Daniel Garcia
SVP, Chief Compliance Officer057713908153220318110668650168990150803600
William Graber
Director024082300000000024082300
J Eugene Grigsby III
Director022100000000000022100000
George Halvorson
Chairman and CEO0124216806949670016085130668650192930988650900
Pamela Hara
VP, Quality/Service0233869055154035322083170018608042612300
Carolyn Hightower
VP, Regional HP Admin - OH01993350104793033457069277019615042647700
Judith Johansen
Director020714600000000020714600
Kim J Kaiser
Director022850000000000022850000
Patricia Kennedy-Scott
Region President - Ohio036618103845630396570149202018608095821100
Joseph M LaGuardia
VP, Mktg, Sls & Bus Devel0151896038416051492052561013974030833900
Kathryn Lancaster
EVP & CFO06502870129745008322520319606013288031128830790044
Fred S Lefton
Dir, Asst Pharmacy Operation01428890573404520037306018577020902600
Donna Lynne
Group President0491921057697504088302098120142690133386000
Philip Marineau
Director022561800000000022561800
Thomas Meier
SVP, Corporate Treasurer031895104599750371560113460016288094583000
Jenny Ming
Director021432300000000021432300
Donald Orndoff
SVP, NFS039084003527500227510143756016415092651200
Nancy Ellen Paton
Exec Dir, Public Affairs01882700003745018422017833022827000
Edward Pei
Director0206641000001700000022364100
Margaret E Porfido
Director023777900000000023777900
J Neal Purcell
Director025146400000000025146400
Thomas Revis
Former VP, CFO - Ohio00000233128046036014533029369700
ROCHELLE ROTH
Exec Dir, Health Plan QCSO0167060032120045864034254012932029223000
Arthur Southam
EVP, Health Plan Operations0755588015301020106468603644230155660373036501019527
Deborah Stokes
SVP, CC & CAO0347253027849606474401299810132880833762043578
Cynthia Telles
Director022671700000000022671700
Belva Tibbs
VP, Medical Operations02238950100415016356070245019588043049900
Bernard J Tyson
President & COO0932699020873520106704206055500193950471203801036741
Jeffrey Wallace
Dir, Pharmacies01535620810007053048919019352023698600
Steven Zatkin
Former Gen. Counsel/Consultant099000288225025376067392014194040508700
Victoria Zatkin
VP, Off of Brd & Corp Gov Svcs0196294010613303684408427502271042581700
Mark Zemelman
SVP, Gen Counsel & Secretary0465119038715201667950214482015015012485630124315

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Schedule J, part IIJ. 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.
Schedule J, Part I, Line 4aJoseph 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.SEVERANCE PAYMENTS
Schedule J, Part I, Line 4bGEORGE HALVORSON $ 1,500,000 KATHRYN LANCASTER 790,314 THOMAS MEIER 858 ARTHUR SOUTHAM 1,019,527 DEBORAH STOKES 43,578 BERNARD TYSON 1,036,741 STEVEN ZATKIN 5,087 MARK ZEMELMAN 126,344 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.SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS
Schedule J, Part I, Line 7The 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.NON-FIXED PAYMENTS

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (14 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 4Changes to governing documentsThe 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.
Form 990, Part VI, Line 6KAISER 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, Line 7aKaiser 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.
Form 990, Part VI, Line 7bThe 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, Line 11bForm 990 review process1. 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.
Form 990, Part VI, Line 12cCOMPLIANCE ENFORCEMENTA. 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.
Form 990, Part VI, Line 15a/bCOMPENSATION DETERMINATIONThe 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, Line 18available on www.guidestar.org.
Form 990, Part VI, Line 19PUBLIC INSPECTIONGoverning 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
Form 990, Part VII, Section A, Column BHOURS FOR RELATED ORGANIZATIONHours 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.
Form 990, Part XI, Line 9Other changes in net assets or fund balancesChange in Other Comprehensive Income 8,143,247 Gain/Loss on investments - Tax < 1,003,012 > Gain/Loss on Investments - Book 1,205,220 Other Than Temporary Impairments < 121,194 > ________________ TOTAL $ 8,224,261
Form 990, Part III, Line 4a - 4dExempt Purpose Achievements - Program Services2012 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.
a. CARE AND COVERAGE FOR LOW-INCOME PEOPLEIN 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.
B. COMMUNITY HEALTH INITIATIVES (CHI)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 & 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.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (14 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Kaiser Foundation Health Plan Inc
One Kaiser Plaza 15LOaklandCA94612941340523Health CareCA501(C)(3)9NAfalse
Kaiser Foundation Health Plan of CO Inc
One Kaiser Plaza 15LOaklandCA94612840591617Health CareCO501(C)(3)9KFHP INCtrue
Kaiser Foundation Health Plan of GA Inc
One Kaiser Plaza 15LOaklandCA94612581592076Health CareGA501(C)(3)9KFHP INCtrue
Kaiser Foundation Health Plan of the MAS
One Kaiser Plaza 15LOaklandCA94612520954463Health CareMD501(C)(3)9KFHP INCtrue
Kaiser Foundation Health Plan of the NW
One Kaiser Plaza 15LOaklandCA94612930798039Health CareOR501(C)(3)9KFHP INCtrue
Kaiser Foundation Hospitals
One Kaiser Plaza 15LOaklandCA94612941105628Health CareCA501(C)(3)3KFHP INCtrue
Camp Bowie Service Center
One Kaiser Plaza 15LOaklandCA94612943299123AdminCA501(C)(3)11 - IKFHP INCtrue
Kaiser Health Alternatives
One Kaiser Plaza 15LOaklandCA94612930954562Health CareOR501(C)(3)9KFHP INCtrue
Kaiser Hospital Asset Management Inc
One Kaiser Plaza 15LOaklandCA94612943299125Asset MgtCA501(C)(3)11 - IKFHtrue
Kaiser Health Plan Asset Management Inc
One Kaiser Plaza 15LOaklandCA94612943299124Asset MgtCA501(C)(3)11 - IKFHP INCtrue
Lokahi Assurance Ltd
One Kaiser Plaza 15LOaklandCA94612912171891Risk mgmtHI501(C)(3)11 - IKFHP INCtrue
OHP
One Kaiser Plaza 15LOaklandCA94612930480268LeasingWA501(C)(3)11 - IKFHP INCtrue
1800 Harrison Foundation
ONE KAISER PLAZA 15LOAKLANDCA94612943317484FINANCINGCA501(C)(3)11 - IIKFHP INCtrue
Kaiser Hospital Assistance Corporation
One Kaiser Plaza 15LOaklandCA94612311779500FINANCINGCA501(C)(3)11 - III-NFKFHtrue

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsCode VCodeVAmountGeneral Or Managing PartnerGeneralOrManagingPartner
HCMS LLC
ONE KAISER PLAZA 15LOAKLANDCA94612203924985CONSULTINGCANAN/A00$0false
KAISER PERMANENTE VENTURES LLC
ONE KAISER PLAZA 15LOAKLANDCA94612272252521INVESTMENTSCANAN/A00$0false

Form990 Schedule R Part IV Form990ScheduleRPartIV (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsControlled OrgControlledOrg
Archimedes Inc
One Kaiser Plaza 15LOaklandCA94612203774729ConsultingCANAC Corp00false
Kaiser Permanente International
One Kaiser Plaza 15LOaklandCA94612943245176ConsultingCANAC Corp00false
Kaiser Permanente Insurance Company
One Kaiser Plaza 15LOaklandCA94612943203402InsuranceCANAC Corp00false
Kaiser Properties Services Inc
One Kaiser Plaza 15LOaklandCA94612943259432Real EstateCANAC Corp00false
Oak Tree Assurance Ltd
One Kaiser Plaza 15LOaklandCA94612030329760InsuranceVTNAC Corp00false
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiestrueReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgtrueLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (27 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
KAISER FOUNDATION HEALTH PLAN INC
l1213967PER AGREEMENT
KAISER FOUNDATION HEALTH PLAN INC
m17019924PER AGREEMENT
KAISER FOUNDATION HEALTH PLAN INC
p15016782PER AGREEMENT
KAISER FOUNDATION HEALTH PLAN INC
q7116497PER AGREEMENT
KAISER FOUNDATION HEALTH PLAN INC
r58951PER AGREEMENT
KAISER FOUNDATION HOSPITALS
a9311918PER AGREEMENT
KAISER FOUNDATION HOSPITALS
e111000000PER AGREEMENT
KAISER FOUNDATION HOSPITALS
l33528942PER AGREEMENT
KAISER FOUNDATION HOSPITALS
m174319109PER AGREEMENT
KAISER FOUNDATION HOSPITALS
p103568786PER AGREEMENT
KAISER FOUNDATION HOSPITALS
q30275614PER AGREEMENT
KAISER FOUNDATION HOSPITALS
r10000000PER AGREEMENT
KAISER FOUNDATION HEALTH PLAN OF COLORADO
l214655PER AGREEMENT
KAISER FOUNDATION HEALTH PLAN OF COLORADO
o596720PER AGREEMENT
KAISER FOUNDATION HEALTH PLAN OF COLORADO
p1229379PER AGREEMENT
KAISER FDN HEALTH PLAN OF GEORGIA INC
l132620PER AGREEMENT
KAISER FDN HEALTH PLAN OF GEORGIA INC
m514833PER AGREEMENT
KFHP OF THE MID-ATLANTIC STATES INC
l170931PER AGREEMENT
KFHP OF THE MID-ATLANTIC STATES INC
m124501PER AGREEMENT
CAMP BOWIE SERVICE CENTER
m1448317PER AGREEMENT
CAMP BOWIE SERVICE CENTER
p72850PER AGREEMENT
KAISER PERMANENTE INSURANCE COMPANY
m12846828PER AGREEMENT
LOKAHI ASSURANCE LTD
l8036393PER AGREEMENT
LOKAHI ASSURANCE LTD
m1875000PER AGREEMENT
LOKAHI ASSURANCE LTD
q8667539PER AGREEMENT
LOKAHI ASSURANCE LTD
r61293411PER AGREEMENT
OAK TREE ASSURANCE LTD
p282245PER AGREEMENT