2013-11-12T12:41:14-06:00 2012-12-31 PRICEWATERHOUSECOOPERS LLP 2001 MARKET ST SUITE 1700 PHILADELPHIA PA 19103 990 2012-01-01 520954463 KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES INC % VP - NATIONAL TAX COMPLIANCE KAIS 5102716611 ONE KAISER PLAZA 15L Suite OAKLAND CA 94612 DEBORAH STOKES 2013-11-06 2673303000 2012 2016-02-25 16:41:14Z KIMBERLY HORN ONE KAISER PLAZA 15L OAKLAND CA 94612 2618675595 false X N/A X 1972 MD TO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE 15 12 6536 678 218917 16275 344247 2272514533 2388129639 7423339 6947254 587969 831446 2280542116 2396252586 6464946 1926096 0 0 509803098 566568795 0 0 0 1817965316 1848484469 2334233360 2416979360 -53691244 -20726774 985638340 1184225388 1007449179 1298675195 -21810839 -114449807 X TO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE false false 2175339308 1926096 2385151394 member health care services and medical training for care improvement Kaiser Foundation Health Plan of the Mid-Atlantic States (KFHP of MAS) 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 MAS educates and trains medical students and other health care professionals and promotes scientific and nursing education in order to improve care. Additional information about Mid-Atlantic States Health Plan's charitable activities can be found in Community Benefits Report. 50234096 0 2696281 Charitable Care (Medical Financial Assistance and Charitable Health Coverage) Mid-Atlantic States Health Plan provides charity care to low-income vulnerable patients through the Medical Financial Assistance (MFA) and Charitable Health Coverage (CHC) Programs. Mid-Atlantic States 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 1,300 qualifying applicants. The CHC programs are available to low income adults and children who are not eligible for other public or privately sponsored coverage. More than 8,400 individuals were receiving comprehensive care through these programs at the end of 2012. Additional information about Mid-Atlantic States Health Plan's charitable activities can be found in Community Benefits Report. 15683863 0 281964 Medicaid and Other Government Sponsored Programs Mid-Atlantic States Health Plan is committed to improving the way beneficiaries of our Medicaid and other government sponsored programs receive care, not only in our facilities, but also in the communities we serve. In 2012, Mid-Atlantic States Health Plan participated in a number of government programs to support the provision of primary and specialty care to residents of the communities we serve. At the end of 2012, approximately 1,200 individuals were receiving the benefits of full membership in KFHP's managed care programs in the Mid-Atlantic region. Additional information about Mid-Atlantic States Health Plan's charitable activities can be found in Community Benefits Report. 10400076 0 0 SEE COMMUNITY BENEFIT REPORT 10400076 0 0 2251657343 true true false true false false false false false false true false false false true false true true false false false false false false false false false true false true false false false false false false false false false false false false false true true true false false true 4820 0 true 6536 true true true false false false false false false false false false X 15 12 false false true false true true true true true false false true true true true true true true true false DC MD VA X X VP - NATIONAL TAX COMPLIANCE 5102716385 ONE KAISER PLAZA 15L OAKLAND CA 94612 X Christine Cassel 1.0 10.0 X 0 203500 0 Thomas Chapman 2.0 11.0 X 0 214108 17000 Daniel P Garcia 2.0 48.0 X X 0 1424272 83764 William Graber 0.5 7.0 X 0 240823 0 J Eugene Grigsby III 1.0 7.5 X 0 221000 0 George C Halvorson 5.0 45.0 X X 0 9800351 86158 Judith Johansen 0.5 5.8 X 0 207146 0 Kim J Kaiser 0.5 8.0 X 0 228500 0 Philip Marineau 0.58 6.34 X 0 225618 0 Jenny Ming 0.3 4.8 X 0 214323 0 Edward Pei 0.5 7.5 X 0 206641 17000 Margaret Porfido 0.5 9.0 X 0 237779 0 J Neal Purcell 0.5 8.5 X 0 251464 0 Cynthia Telles 0.5 6.6 X 0 226717 0 Bernard J Tyson 5.0 45.0 X X 0 4087093 624945 Marilyn Kawamura 40.0 10.0 X 0 913029 86735 Kathryn Lancaster 4.0 46.0 X 0 2779989 332894 Thomas R Meier 3.0 47.0 X 0 816082 129748 Donald H Orndoff 5.0 45.0 X 0 766341 160171 DeAnne Petersen 30.0 20.0 X 0 372576 81079 ROCHELLE M Roth 3.0 47.0 X 0 245044 47186 Arthur M Southam 4.0 46.0 X 0 3350376 379989 Susan Spurlark 30.0 20.0 X 0 352450 113273 Deborah Stokes 4.0 46.0 X 0 690493 143269 Victoria Zatkin 4.0 46.0 X 0 339271 86546 Mark S Zemelman 3.0 47.0 X 0 1019066 229497 Gregory Adams 6.0 44.0 X 0 1910063 311061 Kimberly Horn 30.0 20.0 X 0 112249 29632 Russell K Bradley 30.0 20.0 X 0 284005 71504 Ruben J Burnett 30.0 20.0 X 0 471098 103016 Linda M Collins 30.0 20.0 X 0 440040 108839 Mary Elizabeth Jaeger 30.0 20.0 X 0 292325 80738 Kay W Lewis 30.0 20.0 X 0 355377 126131 Ferial G Maghami 30.0 20.0 X 0 485980 55340 Karen Elizabeth Blair 30.0 20.0 X 0 239950 72226 Tamsen Westmoreland 30.0 20.0 X 0 236940 53787 Steven R Zatkin 0.0 0.0 X 0 323501 81586 Kendall D Hunter 0.0 0.0 X 0 651595 112463 0 35437175 3825577 864 true true false MID-ATLANTIC PERMANENTE MEDICAL GRO 2101 EAST JEFFERSON STREET ROCKVILLE MD 20852 PHYSICIAN SERVICES 472497676 INOVA GROUP OF HOSPITALS PO BOX 37019 BALTIMORE MD 21297 HOSPITAL SERVICES 60833042 HOLY CROSS HOSPITAL 9805 DAMERON DRIVE SILVER SPRING MD 20902 HOSPITAL SERVICES 56276250 WASHINGTON HOSPITAL CENTER PO BOX 631290 BALTIMORE MD 21263 HOSPITAL SERVICES 59622963 VIRGINIA HOSPITAL CENTER PO BOX 1494 MERRIFIELD MD 22116 HOSPITAL SERVICES 45581215 394 313647 30600 344247 MBR HLTH CARE PREM 621400 1983070458 1983070458 SUPPL CHARGE/PHARM 621400 102395601 102256146 139455 NON-PLAN & IND REV 621400 3960347 3960347 OTHER PRGM SERVICE 621400 19642220 19562758 79462 MEDICARE/MEDICAID 621400 279061013 279061013 2388129639 5911574 5911574 0 0 831446 831446 0 831446 831446 223451964 6725 222174225 248784 1277739 -242059 1035680 1035680 0 0 0 0 2396252586 2387910722 218917 7778700 1926096 1926096 0 0 0 0 0 398099193 359450059 38649134 0 59213443 59213443 79702014 79292837 409177 29554145 12216138 17338007 0 2029332 2029332 1203384 1203384 618518 618518 0 153418 153418 0 9978364 527552 9450812 8686103 7597158 1088945 139501851 110560643 28941208 0 49967377 49967377 2441956 1738010 703946 0 1234366 1234366 8664884 8664884 0 53106381 53106381 22728904 22660610 68294 CONTRACTUAL PAYMENTS 704152133 704152133 PURCHASED MEDICAL SERVICES 314482462 314482462 SUPPLIES 329471817 300147457 29324360 INTER-REGIONAL CHARGES 91012168 91012168 109051051 74941935 34109116 2416979360 2251657343 165322017 0 8202358 8391431 0 0 0 0 70625433 101127836 0 0 0 0 0 0 22901293 25010224 6011700 6539876 1215143183 455944854 581134560 759198329 292101623 280946152 0 0 0 0 0 0 4661373 3011540 985638340 1184225388 241645685 246820670 0 0 17315489 12711369 12913877 12888484 0 0 0 0 0 0 0 0 735574128 1026254672 1007449179 1298675195 X 6795610 6795610 0 0 -28606449 -121245417 -21810839 -114449807 985638340 1184225388 X -20726774 -359514 -71552680 X false true X true true true X 0 1000 0 16275 344247 361522 2001419294 2072423301 2167352747 2272514533 2388129639 10901839514 0 0 0 2001419294 2072424301 2167352747 2272530808 2388473886 10902201036 0 0 0 10902201036 16584560 13960781 11014664 6430418 6743020 54733443 0 16584560 13960781 11014664 6430418 6743020 54733443 0 0 2018003854 2086385082 2178367411 2278961226 2395216906 10956934479 0.99501 0.99391 0.00500 0.00609 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false true 18000 true 370022 true true 230496 618518 false LOBBYING ACTIVITY BY NONELECTING PUBLIC CHARITIES SCHEDULE C, PART II-B, LINE 1A THROUGH 1I 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. 69588980 69588980 602471890 221714171 380757719 148545924 62428006 86117918 232612909 151387220 81225689 161923480 20415457 141508023 759198329 0 DUE TO RELATED ENTITIES 316931242 SELF-INSURED RISKS 120262211 MEDICARE COST REPORT RESERVE 34825079 PENSION & POST-RETIREMENT BENEFITS 350882919 OTHER CURRENT LIABILITIES 32086668 OTHER LONG-TERM LIABILITIES 171266553 1026254672 2392083992 -359514 -490457 -849971 2392933963 2055550 1263073 3318623 2396252586 2412925866 248784 248784 2412677082 153418 4148860 4302278 2416979360 RECONCILIATION OF REVENUE PER AUDITED FIN. STMT. WITH REVENUE PER RETURN SCHEDULE D, PART XI LINE 2D: Gain on sale of investments - book $ 1,756,271 Bad Debt Reclass <2,093,310> INVESTMENT MANAGEMENT RECLASS <153,468> TOTAL $ <490,457> LINE 4A: INTEREST EXPENSE - RECLASS 2,055,550 LINE 4B: Gain on sale of investments - tax $ 1,277,739 Fixed assets loss - reclass <248,784> OTTI (See Note 1) 234,118 TOTAL $ 1,263,073 Note 1: other than temporary impairment (OTTI) of investment recognized for financial statement purposes, which will be tax reported when realized. RECONCILIATION OF EXPENSES PER AUDITED FIN. STMT. WITH EXPENSES PER RETURN SCHEDULE D, PART XII LINE 2D: FIXED ASSET LOSS - RECLASS $ 248,784 LINE 4A: INVESTMENT MANAGEMENT EXPENSES - RECLASS $ 153,418 LINE 4B: BAD DEBT EXPENSES - RECLASS $ 2,093,310 INTEREST EXPENSE - RECLASS 2,055,550 TOTAL $ 4,148,860 SCHEDULE D, PART X, Line 2 FIN 48 FOOTNOTE The organization's financial statements do not include a footnote under FIN 48. true Access Carroll Inc 2 Locust Lane 301 Westminister MD 21157 202146701 501(c)(3) 48024 Uninsured Project Access Coordinator and Medication Coordinator Act for Alexandria 1421 Prince St 400 Alexandria VA 22314 264322369 501(c)(3) 69215 Food & Play Support Alexandria Neighborhood Health Services 2445 Army Navy Dr 104 Alexandria VA 22206 541849881 501(c)(3) 50000 Improving Access American University 4400 Massachusetts Ave NW Gray Hall Washington DC 20016 530196549 501(c)(3) 68967 Measuring the Impact Arlington Free Clinic 2921 11th St South Arlington VA 22204 541671883 501(c)(3) 52800 Voila Paris Gala Arlington Pediatric Center Inc 1701 N George Mason Dr Arlington VA 22205 541998631 501(c)(3) 72300 Pediatric center Baltimore Office of Promotion and The Arts 7 East Redwood St 500 Baltimore MD 21202 900091850 501(c)(3) 16000 Eat Fresh@Baltimore Bread for the City Inc 1525 Seventh St NW Washington DC 20001 521138207 501(c)(3) 55000 DC Food Support Catoctin Foundation Inc 224B Cornwall St NW Leesburg VA 20176 541921059 501(c)(3) 50000 Loudoun Free Clinic Collaborative Chase Brexton Health Services Inc 1001 Cathedral St Baltimore MD 21201 521638592 501(c)(3) 50000 Implementation Ptn Crossroads Community Food Network Inc 6930 Carroll Ave 426 Takoma Park MD 20912 364635237 501(c)(3) 50000 Fresh Checks:Healthy DC Central Kitchen Inc 425 2nd St NW Washington DC 20001 521584936 501(c)(3) 75000 Healthy Corners Engaged Community Offshoots Inc 3901 Livingston St Hyattsville MD 20781 264196401 501(c)(3) 75000 Cultivating Wellness Everybody Wins DC 1213 K Street NW Washington DC 20005 521938281 501(c)(3) 40000 Lead MentorCorporate Fairfax County Park Foundation Inc 12055 Government Ctr Pkwy Suite 404 Fairfax VA 22035 542019179 501(c)(3) 10000 Take 12 for Health Family & Medical Counseling Service Inc 2041 MLK Jr Ave SE Washington DC 20020 521073362 501(c)(3) 42194 PCMH Recognition Food & Friends Inc 219 Riggs Road NE Washington DC 20011 521648941 501(c)(3) 20000 Food & Friends Thank Food Research & Action Center Inc 1875 Connecticut Ave NW 540 Washngton DC 20009 237200739 501(c)(3) 155000 Fighting Hunger Mary Fredericksburg Area Regional Health Inc 1301 Sam Perry Bld Fredericksburg VA 22401 541677934 501(c)(3) 50000 Electronic MedRecord Inquiring Systems Inc PO Box 2037 Sonoma CA 95476 942524840 501(c)(3) 15703 Farm to Desk:Wrap Up Interfaith Works Inc 114 W Montgomery Ave Rockville MD 20854 521072684 501(c)(3) 7500 Fables & Tables Joint Center PoliticalEconomic Studies 805 Fifteenth St NW 2nd Floor Washington DC 20005 521069070 501(c)(3) 10000 PLACE MATTERS Junior Achievement of National Capital Area 1725 I St NW 200 Washington DC 20006 540788947 501(c)(3) 25000 Jr Achieve Finance Lexington Market Inc 400 West Lexington St Baltimore MD 21201 521163034 501(c)(3) 50230 Get Fresh Lexington Nation's Capital Loudoun Community Health Center 224 Cornwall St NW Leesburg VA 20176 202379419 501(c)(3) 51700 Blue Jean Ball Fund Meals on Wheels of Central Maryland Inc 515 South Haven St Baltimore MD 21224 526074723 501(c)(3) 9650 20th Annual Culinary Medical Care For Children Partnership Fdn 1616 Anderson Road McLean VA 22102 261756738 501(c)(3) 8670 Dress Up w/Grown-Ups Mission Life Center 10721 Main St 1200 Fairfax VA 22030 752999280 501(c)(3) 15000 Annual Fundraiser Montgomery Cty Business Round for Education 6010 Executive Blvd Suite 708 Rockville MD 20852 412047342 501(c)(3) 16000 Comprehensive Prog National Trust Hist Preservation the US 1785 Massachusetts Ave NW Washgtn DC 20036 530210807 501(c)(3) 50000 Acadias Mobile Mrket Parks & People Fdn For Baltimore R & P 800 Wyman park Dr 010 Baltimore MD 21211 521349346 501(c)(3) 13410 Docs in Park Events Playworks Education Energized 380 Washington St Oakland CA 94607 943251867 501(c)(3) 50000 Playworks Project Gala Prince William Health Partners Inc 2296 Opitz Blvd 200 Woodbridge VA 22191 030444689 501(c)(3) 49380 Chronic Dis Prevent SOME Inc 71 O Street NW Washington DC 20001 237098123 501(c)(3) 10000 Direct Service Sup St Agnes Hospital Foundation Inc 900 Caton Ave MS 123 Baltimore MD 21229 521415083 501(c)(3) 6750 Caritas: Saint Agnes Career Success Program graduates Suitland Family and Life Development Corp 14416 Old Mill Rd SUITE 101 Upper Marlboro MD 20772 522052386 501(c)(3) 50000 Farmer's Market The Community Foundation Northern Virginia 8283 Greensboro Dr McLean VA 22102 510232459 501(c)(3) 10000 Mission Mercy 2012 The Community Foundation Natl Capital Reg 1201 15th St NW 420 Washington DC 20005 237343119 501(c)(3) 10000 2012 CivicLeadership The Friends of the National Arboretum Inc 3501 New York Ave NE Washington DC 20002 521257712 501(c)(3) 75000 School Garden Well children to medical homes Ulman Fund Inc 921 E Fort Ave 325 Baltimore MD 21230 522057636 501(c)(3) 8000 Blue Jeans Ball United Research and Education Foundation 1901 Pennsylvania Ave NW 1100 Washington DC 20006 541880528 501(c)(3) 50000 Let's Move SaladBars Us Helping Us-People Into Living Inc 3636 Georgia Ave NW Washington DC 20010 521628279 501(c)(3) 10000 Fall Reception Virginia Hospital Center Foundation 1701 N George Mason Dr Arlington VA 22205 204129901 501(c)(3) 9880 A Signature Evening Sciences Students Virginia Hospital Research and Ed Foundation PO Box 31394 Richmond VA 23294 540801059 501(c)(3) 25000 Health Innovation Luncheon Washington Regional Assoc of Grantmakers 1400 16th St NW 740 Washington DC 20036 521756853 501(c)(3) 110000 WRAG's Health Works Washington Urban League Inc 2901 14th St NW Washington DC 20009 530208981 501(c)(3) 23400 75 Years We're Just patients Whitman-Walker Clinic 1701 14th St NW Washington DC 20009 521122122 501(c)(3) 50000 PrimaryCare Medical 47 0 PROCEDURES FOR MONITORING THE USE OF GRANTS SCHEDULE I, PART I, LINE 2 Grantees are required to sign a memorandum of understanding with Health plan prior to grant funds dispersal. grantees are required to submit a final report which delineates accomplishments, relates to stated objectives, and describes the evaluation method used to assess accomplishments. true true false false false false false true false Russell K Bradley 0 187718 0 78299 0 17988 0 57149 0 14355 0 355509 0 0 Ruben J Burnett 0 238603 0 137746 0 94749 0 90161 0 12855 0 574114 0 74728 Christine Cassel 0 203500 0 0 0 0 0 0 0 0 0 203500 0 0 Thomas Chapman 0 214108 0 0 0 0 0 17000 0 0 0 231108 0 0 Linda M Collins 0 278731 0 73579 0 87730 0 95984 0 12855 0 548879 0 0 Daniel P Garcia 0 577139 0 815322 0 31811 0 66865 0 16899 0 1508036 0 0 William Graber 0 240823 0 0 0 0 0 0 0 0 0 240823 0 0 J Eugene Grigsby III 0 221000 0 0 0 0 0 0 0 0 0 221000 0 0 George C Halvorson 0 1242168 0 6949670 0 1608513 0 66865 0 19293 0 9886509 0 0 Mary Elizabeth Jaeger 0 198706 0 70181 0 23438 0 66572 0 14166 0 373063 0 0 Judith Johansen 0 207146 0 0 0 0 0 0 0 0 0 207146 0 0 Kim J Kaiser 0 228500 0 0 0 0 0 0 0 0 0 228500 0 0 Marilyn Kawamura 0 320565 0 406594 0 185870 0 75550 0 11185 0 999764 0 142071 Kathryn Lancaster 0 650287 0 1297450 0 832252 0 319606 0 13288 0 3112883 0 790044 Kay W Lewis 0 199962 0 67208 0 88207 0 113172 0 12959 0 481508 0 68221 Ferial G Maghami 0 46634 0 121571 0 317775 0 42018 0 13322 0 541320 0 115547 Philip Marineau 0 225618 0 0 0 0 0 0 0 0 0 225618 0 0 Thomas R Meier 0 318951 0 459975 0 37156 0 113460 0 16288 0 945830 0 0 Jenny Ming 0 214323 0 0 0 0 0 0 0 0 0 214323 0 0 Donald H Orndoff 0 390840 0 352750 0 22751 0 143756 0 16415 0 926512 0 0 Edward Pei 0 206641 0 0 0 0 0 17000 0 0 0 223641 0 0 DeAnne Petersen 0 232853 0 123855 0 15868 0 68224 0 12855 0 453655 0 0 Margaret Porfido 0 237779 0 0 0 0 0 0 0 0 0 237779 0 0 J Neal Purcell 0 251464 0 0 0 0 0 0 0 0 0 251464 0 0 ROCHELLE M Roth 0 167060 0 32120 0 45864 0 34254 0 12932 0 292230 0 0 Arthur M Southam 0 755588 0 1530102 0 1064686 0 364423 0 15566 0 3730365 0 1019527 Susan Spurlark 0 233895 0 98639 0 19916 0 99951 0 13322 0 465723 0 0 Deborah Stokes 0 347253 0 278496 0 64744 0 129981 0 13288 0 833762 0 43578 Cynthia Telles 0 226717 0 0 0 0 0 0 0 0 0 226717 0 0 Bernard J Tyson 0 932699 0 2087352 0 1067042 0 605550 0 19395 0 4712038 0 1036741 Steven R Zatkin 0 9900 0 288225 0 25376 0 67392 0 14194 0 405087 0 0 Victoria Zatkin 0 196294 0 106133 0 36844 0 84275 0 2271 0 425817 0 0 Mark S Zemelman 0 465119 0 387152 0 166795 0 214482 0 15015 0 1248563 0 124315 Gregory Adams 0 645713 0 1012443 0 251907 0 293536 0 17525 0 2221124 0 227113 Karen Elizabeth Blair 0 184466 0 22286 0 33198 0 58124 0 14102 0 312176 0 0 Tamsen Westmoreland 0 177273 0 47560 0 12107 0 38549 0 15238 0 290727 0 0 Kendall D Hunter 0 312045 0 172750 0 166800 0 99608 0 12855 0 764058 0 112463 SCHEDULE J, PART I, LINE 3 Top Management Officials' Compensation Kaiser Foundation Health Plan of the Mid-Atlantic States relied on Kaiser Foundation Health Plan, Inc. that used one or more of the methods described below to establish the top management officials' compensation: - Compensation committee - Independent compensation consultant - Form 990 of other organizations - Written employment contract - Compensation survey or study, and - Approval by the board or compensation committee. SCHEDULE J, PART I, LINE 4a SEVERANCE PAYMENTS Ferial Maghami $ 177,188 Listed persons participated in arrangements entitling them to severance benefits in the event of termination by the organization without cause or due to job elimination. Depending on position level, tenure, and termination reason, severance benefits payable under these arrangements provide for pay and health benefits continuation plus payment of accrued obligations. In addition, for some of the listed persons, severance benefits payable include prorated incentive awards for performance periods not yet ended. None of the listed persons participated in arrangements entitling them to change-of-control payments. SCHEDULE J, PART I, LINE 4b SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN George Halvorson $ 1,500,000 Mark Zemelman 126,344 Marilyn Kawamura 144,894 Kay Lewis 68,221 Deborah Stokes 43,578 Steven Zatkin 5,087 Thomas Meier 858 ferial maghami 115,547 bernard tyson 1,036,741 arthur southam 1,019,527 gregory adams 227,113 Kathryn Lancaster 790,314 Ruben Burnett 74,728 Some of the listed persons participated in nonqualified supplemental retirement plans. Under these plans, the organization makes annual contributions to accounts held in the name of individual participants. Contributions vary by position level and pay, and vest over time based on age and/or service. Participant accounts are credited with actual investment returns from up to four mutual funds and/or with a fixed rate of interest or a combination thereof. Unvested amounts are subject to risk of forfeiture. SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS The organization provided non-fixed payments to some of the persons listed. Payments were made under incentive plans, based on attainment of organizational performance goals and individual performance, designed to support the organization's mission to provide high-quality, affordable care and improve the health of its members and the communities it serves. SCHEDULE J, PART II Steven Zatkin - general counsel to 06/30/2010; consultant 3/4/2011 to present. Bernard Tyson - Board of Directors effective 12/06/2012. J Neil Purcell - Board of Directors to 12/31/2012. Marilyn Kawamura - President to 10/15/2012. Kimberly Horn - President effective 10/15/2012. form 990, PART I, LINE 7B Net Unrelated Business Taxable Income from Form 990-T, Line 34 TOTAL UBI (FORM 990-T, LINE 30) $ 33,674 NET OPERATING LOSS (NOL) APPLIED (33,674) UBTI WITH NOL (FORM 990-T, LINE 34) NONE form 990, PART III, LINE 4A-D 2012 COMMUNITY BENEFIT REPORT KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. 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 THE MID-ATLANTIC STATES: IN 2012, THE MID-ATLANTIC HEALTH PLAN SERVED 481,986 MEMBERS AND EXPENDED $75.6 MILLION (AT COST, NET OF $2.9 MILLION OF RELATED REVENUES) TO SUPPORT COMMUNITY BENEFIT ACTIVITIES. THE FOLLOWING SUMMARIZES MANY OF THE SIGNATURE COMMUNITY BENEFIT PROGRAMS AND SERVICES GROUPED ACCORDING TO THE NATIONAL STREAMS OF WORK. A. CARE AND COVERAGE FOR LOW-INCOME PEOPLE IN 2012, THE MID-ATLANTIC HEALTH PLAN EXPENDED $62.9 MILLION (AT COST, NET OF $2.9 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 THE MID-ATLANTIC REGION, HEALTH PLAN PROVIDES CHARITY CARE TO LOW-INCOME VULNERABLE POPULATIONS THROUGH THE MEDICAL FINANCIAL ASSISTANCE AND CHARITABLE HEALTH COVERAGE PROGRAMS. IN 2012, THE MID-ATLANTIC STATES HEALTH PLAN SPENT $47.5 MILLION (AT COST, NET OF $2.7 MILLION OF RELATED REVENUES) ON UNDER- AND UNINSURED PATIENTS. MEDICAL FINANCIAL ASSISTANCE PROGRAM THE MEDICAL FINANCIAL ASSISTANCE (MFA) PROGRAM HELPS LOW-INCOME, UNINSURED, AND UNDERSERVED PATIENTS RECEIVE ACCESS TO CARE. THE PROGRAM PROVIDES TEMPORARY FINANCIAL ASSISTANCE OR FREE CARE TO PATIENTS WHO RECEIVE HEALTH CARE SERVICES FROM OUR PROVIDERS, REGARDLESS OF WHETHER THEY HAVE HEALTH COVERAGE OR ARE UNINSURED. MID-ATLANTIC HEALTH PLAN FUNDED APPROXIMATELY $7.6 MILLION (AT COST, NET OF RELATED REVENUES) TO THIS PROGRAM IN 2012, BENEFITTING OVER 1,300 QUALIFIED APPLICANTS. 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 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 DESCRIBES TWO CHC PROGRAMS IN THE MID-ATLANTIC REGION. MORE THAN 8,400 MEMBERS WERE RECEIVING COMPREHENSIVE CARE THROUGH THESE PROGRAMS AT THE END OF 2012. APPROXIMATELY $40.0 MILLION (AT COST, NET OF RELATED REVENUES) WAS SPENT ON THESE PROGRAMS DURING THE YEAR. - BRIDGE PROGRAM - THIS PROGRAM ALLOWS LOW-INCOME INDIVIDUALS AT LESS THAN 300% OF FEDERAL POVERTY GUIDELINES WHO ARE FACING FINANCIAL DIFFICULTIES TO APPLY FOR SUBSIDIZED COVERAGE. IN ORDER TO QUALIFY FOR BRIDGE COVERAGE, INDIVIDUALS MUST NOT BE ELIGIBLE FOR ANY OTHER PUBLIC OR PRIVATE HEALTH CARE COVERAGE. - MEDICAL CARE FOR CHILDREN PARTNERSHIP PROGRAM - MID-ATLANTIC HEALTH PLAN PARTICIPATES AS A PRIMARY CARE PROVIDER WITHIN OUR FACILITIES FOR THE FIVE COMMUNITY PARTNERSHIPS WHO ADMINISTER THIS PROGRAM FOR ELIGIBLE CHILDREN IN MARYLAND AND VIRGINIA. THE PROGRAMS ARE ADMINISTERED THROUGH LOCAL GOVERNMENTAL AGENCIES AND NON-PROFIT ORGANIZATIONS. ELIGIBILITY IS RESTRICTED TO THOSE CHILDREN UNDER 300% OF FEDERAL POVERTY GUIDELINES WHO ARE NOT ELIGIBLE FOR ANY OTHER PUBLIC OR PRIVATE HEALTHCARE. 2. PARTICIPATION IN MEDICAID AND OTHER GOVERNMENT-SPONSORED PROGRAMS IN 2012, MID-ATLANTIC HEALTH PLAN CONTRIBUTED $15.4 MILLION (AT COST, NET OF $200 THOUSAND OF RELATED REVENUES) TO SUPPORT THE PROVISION OF MEDICAL CARE SERVICES TO INDIVIDUALS IN THE FOLLOWING GOVERNMENT-SPONSORED PROGRAMS: - THE MARYLAND MEDICAL ASSISTANCE PROGRAM PROVIDES RESOURCES THAT SUPPORT HEALTHCARE TO VULNERABLE POPULATIONS BY INCREASING THE NUMBER OF PROVIDERS WILLING TO SERVE MEDICAID PATIENTS. - MEDICAID - KAISER PERMANENTE SERVED APPROXIMATELY 1,200 NON-MEMBER MEDICAID PEDIATRIC PATIENTS AS A PRIMARY CARE PROVIDER THROUGH PRIORITY PARTNERS AT EIGHT MEDICAL OFFICES IN 2012. THE MID-ATLANTIC HEALTH PLAN IS ALSO ON THE PATH TO BECOME A MEDICAID MANAGED CARE ORGANIZATION (MCO). MUCH OF 2012 WAS SPENT ON IMPLEMENTATION AND EXECUTION FOR A PLANNED GO-LIVE DATE IN JULY 2013 FOR VIRGINIA AND JANUARY 1, 2014 FOR MARYLAND. IN 2012, THE MID-ATLANTIC HEALTH PLAN FUNDED COST-BASED LOSSES OF $873 THOUSAND UNDER THE PROGRAM WITH MEDICAID MCO START UP COSTS OF $3.4 MILLION. B. COMMUNITY HEALTH INITIATIVES (CHI) THE MID-ATLANTIC HEALTH PLAN SPENT APPROXIMATELY $1.0 MILLION ON COMMUNITY HEALTH INITIATIVES DURING 2012 BY AWARDING CHARITABLE CONTRIBUTIONS TO NONPROFIT ORGANIZATIONS AND GOVERNMENT AGENCIES. THE FOLLOWING ARE EXAMPLES OF THE RESOURCES CONTRIBUTED BY THE MID-ATLANTIC STATES HEALTH PLAN TO SUPPORT COMMUNITY HEALTH INTIATIVES IN THE AREA. HEALTHY EATING ACTIVE LIVING (HEAL) PROGRAMS MID-ATLANTIC HEALTH PLAN SUPPORTS EFFORTS TO INCREASE ACCESS TO HEALTHY FOODS IN NEIGHBORHOODS, SCHOOLS, AND WORKPLACES ACROSS THE REGION, WITH A FOCUS ON VULNERABLE POPULATIONS. THIS INCLUDES FUNDING AND OTHER RESOURCES PROVIDED TO FOOD POLICY COUNCILS, FARMERS MARKETS, COMMUNITY FARMS AND GARDENS, HEALTHY GROCERY AND CORNER STORE INITIATIVES, HEALTHY FOOD BANKING, ETC. KAISER PERMANENTE IS A FOUNDING MEMBER OF THE MID-ATLANTIC REGIONAL CONVERGENCE PARTNERSHIP OF WASHINGTON REGIONAL AREA GRANTMAKERS, A COLLABORATION OF FUNDERS DEDICATED TO HELPING CREATE SUSTAINABLE AND EQUITABLE FOOD SYSTEMS TO SERVE THE REGION. - THE MID-ATLANTIC HEALTH PLAN IS HOST TO A FARMERS MARKET AT OUR BALTIMORE CITY PLAZA MEDICAL CENTER, FARM STANDS AT OUR LARGO, CAMP SPRINGS, AND MARLOW HEIGHTS MEDICAL CENTERS AND OUR REGIONAL OFFICE BUILDING, AND A COMMUNITY GARDEN AT THE WHITE MARSH MEDICAL CENTER. - KEY HEAL PARTNERSHIPS INCLUDE: THE PORT TOWNS COMMUNITY HEALTH PARTNERSHIP, PLAYWORKS, SAFE ROUTES TO SCHOOLS, FOOD RESEARCH ACTION CENTER, DC CENTRAL KITCHEN, BALTIMORE CITY OFFICE OF SUSTAINABILITY, AND THE INSTITUTE FOR PUBLIC HEALTH INNOVATION. - THE PORT TOWNS COMMUNITY HEALTH PARTNERSHIP WAS LAUNCHED IN 2008 BY KAISER PERMANENTE IN COLLABORATION WITH OTHER ORGANIZATIONS. THIS IS A 5-7 YEAR INVESTMENT THAT PROVIDES TECHNICAL ASSISTANCE, PROJECT MANAGEMENT, AND EVALUATION SUPPORT TO IMPROVE POLICIES, PRACTICES, AND PROGRAMS THAT INFLUCENCE HEALTH IN A COUNTY THAT SUFFERS SOME OF THE HIGHEST RATES OF CHRONIC ILLNESS IN THE STATE. IN 2012, THIS INITIATIVE HELPED ATTRACT MORE THAN $4 MILLION IN FEDERAL GRANTS TO THE COUNTY, AND HAS BEEN CITED AS A MODEL FOR THE COUNTY'S HEALTH IMPROVEMENT PLAN. C. SAFETY NET PARTNERSHIPS THE MID-ATLANTIC HEALTH PLAN SPENT APPROXIMATELY $944 THOUSAND ON SAFETY NET PARTNERSHIPS DURING 2012 BY AWARDING CHARITABLE CONTRIBUTIONS TO NONPROFIT ORGANIZATIONS AND GOVERNMENT AGENCIES. THE FOLLOWING ARE HIGHLIGHTS FROM A FEW OF OUR SIGNATURE SAFETY NET PARTNERSHIPS: - 2012 WAS THE FOURTH YEAR OF THE COMMUNITY AMBASSADOR PROGRAM WHICH GREW FROM TWO NURSE PRACTITIONERS (NPS) TO A TOTAL OF 38 NPS AND PHYSICIAN ASSISTANTS PLACED IN 19 SAFETY NET CLINICS IN WASHINGTON DC, SUBURBAN MARYLAND AND NORTHERN VIRGINIA. THE PURPOSE OF THE PROGRAM IS TO EXPAND THE CAPACITY OF LOCAL SAFETY NET CLINICS TO INCREASE HEALTHCARE ACCESS TO THE UNDER/UNINSURED. - THE HYPERTENSION INITIATIVE IS A PILOT PROGRAM DEVELOPED IN 2011 BETWEEN KAISER PERMANENTE AND THREE FEDERALLY QUALIFIED HEALTH CENTERS, ONE IN WASHINGTON DC, AND TWO IN MARYLAND. THE PROGRAM IS INTENDED TO BUILD A BRIDGE BETWEEN KP AND COMMUNITY CLINICS BY PROVIDING SPECIALTY CARE SPECIFIC TO REFRACTORY HYPERTENSIVE PATIENTS. FULL ROLLOUT IS EXPECTED IN 2013. - IN 2012, THE MID-ATLANTIC REGION COORDINATED WITH THE DIVERSITY DEPARTMENT TO PROVIDE A CULTURALLY-COMPETENT TRAIN THE TRAINER FORUM FOR THE SAFETY NET COMMUNITY. THIS PROJECT RESULTED IN THE CERTIFICATION OF ELEVEN SAFETY NET FACILIATORS FROM OUTSIDE OUR ORGANIZATION. D. DEVELOPING AND DISSEMINATING KNOWLEDGE 1. CLINICAL AND HEALTH SERVICES RESEARCH THE MID-ATLANTIC DEPARTMENT OF RESEARCH CONDUCTS POPULATION-BASED STUDIES, HEALTH SERVICES RESEARCH AND CLINICAL TRIALS TO ANSWER IMPORTANT HEALTH POLICY AND PUBLIC HEALTH QUESTIONS. THESE PROJECTS ARE FUNDED BOTH INTERNALLY AND EXTERNALLY THROUGH FEDERAL AND STATE GOVERNMENT AGENCIES AND OTHER NONPROFIT ORGANIZATIONS SUCH AS UNIVERSITIES AND FOUNDATIONS. BESIDES GUIDING OUR CLINICIANS' PRACTICE PATTERNS AND ENHANCING THE HEALTH AND MEDICAL CARE OF OUR MEMBERS, THIS RESEARCH ALSO CONTRIBUTES TO THE WEALTH OF MEDICAL KNOWLEDGE SHARED THROUGH WIDELY-DISSEMINATED PUBLICATIONS AND PRESENTATIONS. IN 2012, THE MID-ATLANTIC HEALTH PLAN FUNDED APPROXIMATELY $1.4 MILLION TOWARDS MEDICAL RESEARCH PROJECTS. 2. EDUCATIONAL THEATRE PROGRAMS (ETP) THE MID ATLANTIC HEALTH PLAN SPENT APPROXIMATELY $1.0 MILLION IN 2012 TO SUPPORT EDUCATIONAL THEATRE PROGRAMS (ETP) IN THE REGION. THESE PROGRAMS HAVE PROVIDED PROFESSIONAL, AWARD-WINNING HEALTH EDUCATION FOR PRE-KINDERGARTEN TO 12TH GRADE STUDENTS FOR OVER 25 YEARS IN MARYLAND, VIRGINIA, AND THE DISTRICT OF COLUMBIA. IN 2012, ETP GAVE MORE THAN 400 PERFORMANCES FOR APPROXIMATELY 63,000 CHILDREN AND ADULTS AT 173 DIFFERENT SCHOOLS AND OTHER LOCATIONS. ADDITIONALLY, ETP PRODUCED A MUSIC VIDEO DESCRIBING THE BENEFITS OF AND DISPELLING THE MYTHS SURROUNDING SEASONAL FLU SHOTS. E. OTHER COMMUNITY BENEFIT INVESTMENTS IN 2012, THE MID-ATLANTIC HEALTH PLAN SPENT APPROXIMATELY $7.9 MILLION ON OTHER COMMUNITY BENEFITS BEYOND THE NATIONAL STREAMS OF WORK. form 990, part vi, line 4 Changes to governing documents The Articles of Incorporation of the Corporation were amended in 2012 as follows: Articles Third and Sixth were amended to (a) revise the purpose section for consistency with the Articles of Incorporation of Kaiser Foundation Health Plan, Inc. (the member of the Corporation) and its other Health Plan subsidiaries, including making a reference to the Internal Revenue Code (Section 501(c)(3)) consistent with other references in the Articles; and (b) 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. Second Articles of Amendment to Restated Articles of Incorporation of the Corporation were filed May 15, 2012. Minor, non-substantive changes were made to Articles Fourth, Seventh, Eighth and Ninth to: (a) update the information therein (including the names of the current Directors, and the registered agent); (b) make them more consistent with the articles of the Corporation's member, and the articles were fully restated to integrate into one document all of the provisions of the articles currently on file. Second Articles of Amendment and Restatement were submitted for filing and are currently pending regulatory approval. 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 6 kaiser foundation health plan, INC. is the sole member. Upon dissolution, remaining assets shall be distributed to a 501(c)(3) organization. form 990, part vi, LINE 7A 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-CO, OH, NW, and MAS. form 990, PART VI, LINE 7B The following actions of the corporation require approval of the sole member: a) removal of the chairman of the board or the regional president; b) amendments to the bylaws that pertain to the member, the board of directors, or procedures for amending the bylaws (articles c, d, and h of the bylaws); c) amendment of the articles of incorporation. form 990, PART VI, LINE 11B Form 990 Review Process 1. Key information necessary for the preparation of the tax return is obtained and/or confirmed with internal sources including regional finance, executive compensation, community benefits, treasury, government relations, and legal. 2. Community benefits details are presented to the community benefit committee of the board for review. 3. 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 12C Compliance Enforcement A. Regularly and Consistently Monitors Compliance with the Conflicts of Interest Policy - Kaiser Permanente regularly monitors compliance with the Conflicts of Interest Policy in 3 key ways: 1. The Kaiser Permanente Compliance Hotline is available to all employees and vendors to report actual or potential conflicts of interest. All calls are answered by a third party and provided to Kaiser Permanente's National Compliance office for review and appropriate action. Employees can report anonymously and without fear of retaliation. 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 conflicts of interest. Compliance Hotline Reports are provided for review and action to the Kaiser Foundation Health Plan/Hospitals Boards of Directors annually. 2. The National Compliance Office and Internal Audit Services annually review the directors', officers', key employees', and executives' Annual Conflicts of Interest Questionnaire disclosures and provide direction on any investigations required. Investigations are documented, tracked and trended to determine if additional controls or education is required. In addition, Conflicts of Interest Questionnaire Reports are provided for review and action to the Kaiser Foundation Health Plan/Hospitals Boards of Directors annually; and 3. Annually, as a component of the external audit, KPMG reviews the Annual Conflicts of Interest Questionnaires completed by Directors, Officers, Key Employees, and Executives, and actions taken as a result of the disclosures. The results of the annual audit, including any findings in this area are presented to the Kaiser Foundation Health Plan/Hospitals Audit and Compliance Committee. B. Regularly and Consistently Enforces Compliance with the Conflicts of Interest Policy - To ensure consistency in the enforcement of the policy Kaiser Permanente uses the following steps as a general guideline: 1. Represented employees are subject to any corrective/disciplinary action provisions described in specific regional/national collective bargaining agreements and/or organizational policies and practices. 2. Kaiser Permanente notifies employees of the National Human Resources Policy No. 14. Corrective/Disciplinary Action Policy during new employee orientation and in annual compliance training. 3. In the event that it is necessary to discipline any employee because of, but not limited to, failure to comply with applicable legal/regulatory requirements, Kaiser Permanente policies and procedures, or the Principles of Responsibility, or for unsatisfactory performance or misconduct, coaching/counseling and/or corrective/disciplinary action may include, but is not limited to: - Oral discussion and/or warning by the employee's immediate supervisor or higher level manager to correct the problem; - Written notice, with or without final warning; - Paid or unpaid suspension, with or without final warning; - Termination of employment. form 990, PART VI, LINE 15A/B Compensation Determination The executive compensation program is designed to recruit, retain and motivate qualified senior management personnel. Senior management personnel have a significant impact on the strategic and policy direction and results of the organization. Therefore, the executive compensation program is, to a significant degree, performance-based. The compensation program is reviewed annually by the Compensation Committee of the Board of Directors which evaluates and approves, prior to payment, all programs and payments to CEO, Executive Director and top management officials (executives). Base pay for executive positions is established at a level comparable to the relevant market. In addition, other components of the compensation program bear 'at-risk' features designed to focus on strategically important performance goals and to assist in attracting and retaining top performers. The executive compensation program is targeted at the median of the comparable external market in which the organization competes for executive leadership. Evaluation of comparable pay data is performed by an Independent Compensation, Benefit & Human Resource Consulting firm. The compensation program focuses on objectives in the areas of quality of member care and service, financial soundness, and the community and social mission of the organization. Form 990, Part VI, Line 18 Available on GuideStar.org website form 990, Part VI, Line 19 Public Inspection Copy Governing documents - are available from the Department of Insurance and maintained on the state agency website or upon request. Conflict of Interest is available on KP website under vendor Principles of Responsibility or upon request. Financial Statements are on file with state insurance agency on a statutory basis (stand alone entity). Combined data is published for Kaiser Foundation Health Plan Inc. and subsidiaries and Kaiser Foundation Hospitals and Subsidiaries with audit opinion by KPMG and is available upon request. To request copies contact: Vice President - NATIONAL Tax COMPLIANCE Kaiser Foundation Health Plan and Hospitals One Kaiser Plaza, Suite 15L Oakland, CA 94612 form 990, Part VII, section A, column B Hours for Related Organization Individuals who are both officers and members of Boards of Directors work full time as employees as well as fulfill their board assignment. All officers work full time in their employee capacity. Full time work may require in excess of the traditional 40 hour week. Given the integrated nature of our organization, employees may provide support for various Kaiser Permanente companies. The average hours per week reported for the filing organization and related organizations was estimated. Form 990, Part XI, Line 9 Other changes in net assets or fund balances CHANGE IN OTHER COMPREHENSIVE INCOME $ (71,797,094) OTHER THAN TEMPORARY IMPAIRMENTS (234,118) GAIN ON SALE OF INVESTMENTS - TAX (1,277,739) GAIN ON SALE OF INVESTMENTS - BOOK 1,756,271 TOTAL $ (71,552,680) KAISER FOUNDATION HEALTH PLAN INC ONE KAISER PLAZA 15L OAKLAND CA 94612 941340523 HEALTH CARE CA 501(c)(3) 9 NA false KAISER FOUNDATION HOSPITALS ONE KAISER PLAZA 15L OAKLAND CA 94612 941105628 HEALTH CARE CA 501(c)(3) 3 KFHP INC true KAISER FDN HEALTH PLAN OF COLORADO ONE KAISER PLAZA 15L OAKLAND CA 94612 840591617 HEALTH CARE CO 501(c)(3) 9 KFHP INC true KAISER FDN HEALTH PLAN OF GEORGIA INC ONE KAISER PLAZA 15L OAKLAND CA 94612 581592076 HEALTH CARE GA 501(c)(3) 9 KFHP INC true KAISER FDN HEALTH PLAN OF THE NORTHWEST ONE KAISER PLAZA 15L OAKLAND CA 94612 930798039 HEALTH CARE OR 501(c)(3) 9 KFHP INC true KAISER FDN HEALTH PLAN OF OHIO ONE KAISER PLAZA 15L OAKLAND CA 94612 340922268 HEALTH CARE OH 501(c)(3) 9 KFHP INC true KAISER HEALTH PLAN ASSET MANAGEMENT INC ONE KAISER PLAZA 15L OAKLAND CA 94612 943299124 ASSET MGMT CA 501(c)(3) 11 - I KFHP INC true LOKAHI ASSURANCE LTD ONE KAISER PLAZA 15L OAKLAND CA 94612 912171891 RISK MGMT HI 501(c)(3) 11 - I KFHP INC true KAISER HOSPITAL ASSET MANAGEMENT INC ONE KAISER PLAZA 15L OAKLAND CA 94612 943299125 ASSET MGMT CA 501(c)(3) 11 - I KFH true CAMP BOWIE SERVICE CENTER ONE KAISER PLAZA 15L OAKLAND CA 94612 943299123 HEALTH CARE CA 501(c)(3) 11 - I KFHP INC true OHP ONE KAISER PLAZA 15L OAKLAND CA 94612 930480268 LEASING WA 501(c)(3) 11 - I KFHP INC true KAISER HEALTH ALTERNATIVES ONE KAISER PLAZA 15L OAKLAND CA 94612 930954562 HEALTH CARE WA 501(c)(3) 9 KFHP INC true 1800 HARRISON FOUNDATION ONE KAISER PLAZA 15L OAKLAND CA 94612 943317484 FINANCING CA 501(c)(3) 11 - II KFHP INC true KAISER HOSPITAL ASSISTANCE CORPORATION ONE KAISER PLAZA OAKLAND CA 94612 311779500 FINANCING CA 501(c)(3) 11 - III-NF KFH true HCMS LLC ONE KAISER PLAZA 15L OAKLAND CA 94612 203924985 CASE MGMT CA NA NONE false false kaiser permanente ventures LLC one kaiser plaza 15L oakland CA 94612 273339892 investment CA na NONE false false OAK TREE ASSURANCE LTD ONE KAISER PLAZA 15L OAKLAND CA 94612 030329760 INSURANCE VT NA C CORP true KAISER PERMANENTE INSURANCE COMPANY ONE KAISER PLAZA 15L OAKLAND CA 94612 943203402 INSURANCE CA NA C CORP true KAISER PROPERTY SERVICES INC ONE KAISER PLAZA 15L OAKLAND CA 94612 943259432 REAL ESTATE CA NA C CORP true ARCHIMEDES INC ONE KAISER PLAZA 15L OAKLAND CA 94612 203774729 CONSULTING CA NA C CORP true KAISER PERMANENTE INTERNATIONAL ONE KAISER PLAZA 15L OAKLAND CA 94612 943245176 CONSULTING CA NA C CORP true false false false false true false false false false false true true false false true true true true KAISER FOUNDATION HOSPITALS E 89371302 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN INC L 21454454 PER AGREEMENT kaiser foundation hospitals L 68261159 per agreement KAISER FOUNDATION HEALTH PLAN OF COLORADO L 450840 per agreement KAISER FOUNDATION HEALTH PLAN OF GEORGIA L 662794 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN OF THE NW L 312613 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN OF OHIO L 124501 PER AGREEMENT CAMP BOWIE SERVICE CENTER L 8395015 PER AGREEMENT OAK TREE ASSURANCE LTD L 784622 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN INC M 269926917 PER AGREEMENT KAISER FOUNDATION HOSPITALS M 560326257 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN OF COLORADO M 297306 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN OF GEORGIA M 1624336 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN OF THE NW M 121281 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN OF OHIO M 170932 PER AGREEMENT camp bowie service center M 4735983 per agreement KAISER PERMANENTE INSURANCE COMPANY M 14342811 PER AGREEMENT LOKAHI ASSURANCE LTD M 26571152 PER AGREEMENT OAK TREE ASSURANCE LTD M 1025100 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN INC P 94293687 PER AGREEMENT KAISER FOUNDATION HOSPITALS P 33365421 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN OF COLORADO P 576169 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN OF GEORGIA P 168555 PER AGREEMENT camp bowie service center P 406047 per agreement OAK TREE ASSURANCE LTD P 589515 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN INC Q 398427382 PER AGREEMENT KAISER FOUNDATION HOSPITALS Q 242696352 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN of colorado Q 59336 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN OF GEORGIA Q 69646 PER AGREEMENT CAMP BOWIE SERVICE CENTER Q 7481984 PER AGREEMENT LOKAHI ASSURANCE LTD Q 18359569 PER AGREEMENT OAK TREE ASSURANCE LTD Q 330877 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN INC R 1574433 PER AGREEMENT KAISER FOUNDATION HEALTH PLAN INC S 10319252 PER AGREEMENT LOKAHI ASSURANCE LTD S 614000 PER AGREEMENT