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CAMP BOWIE SERVICE CENTER: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
CAMP BOWIE SERVICE CENTER (EIN 94-3299123)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-12
IRS object ID
201213179349302216
Schema version
2011v1.3
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)
Timestamp2012-11-12T14:05:52-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PRICEWATERHOUSECOOPERS LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12001 MARKET STREET SUITE 1700AddressLine1
CityPHILADELPHIACity
StatePAState
ZIP Code19103ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN943299123EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CAMP BOWIE SERVICE CENTERBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% VP - NATIONAL TAX COMPLIANCEInCareOfName
Name ControlCAMPNameControl
Phone5102716611Phone

US Address USAddress

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

Officer Officer

FieldValueIRS element (for citing)
NameDEBORAH STOKESName
TitleSVP, Corporate Controller & CAOTitle
Phone5102716385Phone
Date Signed2012-11-02DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone2673303000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonGERARD L COYNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1ONE KAISER PLAZA 15LAddressLine1
CityOAKLANDCity
StateCAState
ZIP Code94612ZIPCode
FieldValueIRS element (for citing)
Gross Receipts32725217GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1998YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionCAMP BOWIE SERVICE CENTER PROVIDES MEMBERSHIP ACCOUNTING AND ADMINISTRATIVE SUPPORT SERVICES TO THE AFFILIATED EXEMPT ORGANIZATIONS THAT COMPRISE THE KAISER PERMANENTE MEDICAL CARE PROGRAM.ActivityOrMissionDescription
Nbr Voting Members Governing Body3NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year26091582ProgramServiceRevenuePriorYear
Program Service Revenue CY32709734ProgramServiceRevenueCY
Investment Income Prior Year125551InvestmentIncomePriorYear
Investment Income Current Year15483InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year26217133TotalRevenuePriorYear
Total Revenue Current Year32725217TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year6608553SalariesEtcPriorYear
Salaries Etc Current Year18841237SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year19340760OtherExpensePriorYear
Other Expenses Current Year13864974OtherExpensesCurrentYear
Total Expenses Prior Year25949313TotalExpensesPriorYear
Total Expenses Current Year32706211TotalExpensesCurrentYear
Revenues Less Expenses Prior Year267820RevenuesLessExpensesPriorYear
Revenues Less Expenses CY19006RevenuesLessExpensesCY
Total Assets BOY27706609TotalAssetsBOY
Total Assets EOY19227564TotalAssetsEOY
Total Liabilities BOY29096512TotalLiabilitiesBOY
Total Liabilities EOY20856108TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-1389903NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-1628544NetAssetsOrFundBalancesEOY
Mission DescriptionCAMP BOWIE SERVICE CENTER PROVIDES MEMBERSHIP ACCOUNTING AND ADMINISTRATIVE SUPPORT SERVICES TO THE AFFILIATED EXEMPT ORGANIZATIONS THAT COMPRISE THE KAISER PERMANENTE MEDICAL CARE PROGRAM.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense32706211Expense
Revenue32709734Revenue
DescriptionPROCESS INDIVIDUAL MEMBERSHIP RECORDS FOR THE MEMBERS OF THOSE AFFILIATED ORGANIZATIONS THAT COMPRISE THE KAISER PERMANENTE MEDICAL CARE PROGRAM.Description
Total Program Service Expense32706211TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
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 StmtfalseIndependentAuditFinancialStmt
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 OrganizationsfalseGrantsToOrganizations
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 EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Info In Schedule O Part VXInfoInScheduleOPartV
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
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 Members3NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
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 FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

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 (14 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
ARTHUR SOUTHAM MD
DIRECTOR0.1X02649224348687
BERNARD TYSON
DIRECTOR1.0X02800296482152
DONNA LYNNE
DIRECTOR & CHAIR1.0X01314917222947
DEBORAH STOKES
SVP, CC & CAO0.30720302118018X
GERARD L COY
PRESIDENT10.0074568197813X
KATHRYN LANCASTER
EXECUTIVE VP, CFO1.002109102289626X
THOMAS R MEIER
SVP & TREASURER1.00802247110802X
VICTORIA B ZATKIN
ASSISTANT SECRETARY0.5031476884531X
MARK S ZEMELMAN
SECRETARY0.10778576191923X
RUSS HEROLD
SR MANAGER ACCOUNTING50.0014213628990X
CHARLES KIRSCHBAUM
SR OPERATIONS MANAGER50.0012714621333X
CALVIN STRIGGLES
MANAGER - ACCOUNTING50.0011412925713X
BARBARA ISHIKAWA
DIR - MEMBERSHIP ADMIN50.0023689737411X
DENNIS SENTZ
CONTROLLER/MARKETING/SALES20.00338593119066X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs13194014TotalReportableCompFrmRltdOrgs
Total Other Compensation2179012TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
KELLY SERVICES INC
PO BOX 530437ATLANTAGA30353O/S PERSONEL246058
FISERV OUTPUT SOLUTIONS
13100 N PROMENADE BLVDSTAFFORDTX77477PRINTING & DUPL. SVC637385
INSIGHT GLOBAL INC
4170 ASHFORD DUNWOODY RD 580ATLANTAGA30319O/S PERSONEL417171
KFORCE
PO Box 277997ATLANTAGA30384O/S PERSONEL124688
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionMEMBERSHIP SERVICEDescription
Business Code561499BusinessCode
Total Revenue Column32709734TotalRevenueColumn
Related Or Exempt Function Income32709734RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue32709734TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column15483TotalRevenueColumn
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$15,483ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

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 Column32725217TotalRevenueColumn
Related Or Exempt Function Income32709734RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$15,483ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

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)
Total12642755Total
Program Services12642755ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total8170Total
Program Services8170ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total6079176Total
Program Services6079176ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total111136Total
Program Services111136ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total326009Total
Program Services326009ProgramServices

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1997705Total
Program Services1997705ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total141254Total
Program Services141254ProgramServices

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total17257Total
Program Services17257ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total6915840Total
Program Services6915840ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1860860Total
Program Services1860860ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
OUTSIDE MEDICAL SERVICES995131995131
EQUIPMENT RENTAL814263814263
NON-CAPITAL EQUIPMENT8743387433
OUTSIDE NON-MEDICAL SERVICES474475474475

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total234747Total
Program Services234747ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total32706211Total
Program Services32706211ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

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)
BOY0BOY
EOY0EOY

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)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY68547BOY
EOY224055EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis16031746LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec3260829LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3625616BOY
EOY12770917EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

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)
BOY24012446BOY
EOY6232592EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY27706609BOY
EOY19227564EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY827631BOY
EOY229811EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

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)
BOY28268881BOY
EOY20626297EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY29096512BOY
EOY20856108EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

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-1389903BOY
EOY-1628544EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-1389903BOY
EOY-1628544EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY27706609BOY
EOY19227564EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses19006ReconcilationRevenueExpenses
Reconcilation Other Changes-257647ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Certification CheckboxXCertificationCheckbox
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (6 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
KAISER FOUNDATION HEALTH PLAN INC
94134052309truetruetrue$11,245,149
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
93079803909truetruetrue$7,693,049
KASIER FOUNDATION HEALTH PLAN OF COLORADO
84059161709truetruetrue$8,232,249
KAISER FOUNDATION HEALTH PLAN OF GEORGIA
58159207609truetruetrue$3,502,819
KAISER FOUNDATION HEALTH PLAN OF OHIO
34092226809truetruetrue$1,595,185
KFHP OF THE MID-ATLANTIC STATES INC
52095446309truetruetrue$462,981
FieldValueIRS element (for citing)
Total Number Of Supported Orgs6TotalNumberOfSupportedOrgs
Sum Of Amounts32731432SumOfAmounts
General ExplanationCamp Bowie provides membership accounting and administrative support to Kaiser Foundation Health Plan Inc and its subsidiariesGeneralExplanation

Schedule D IRS990ScheduleD

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

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis8725906OtherCostOrOtherBasis
Depreciation1547513Depreciation
Book Value7178393BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis4524310OtherCostOrOtherBasis
Depreciation1144562Depreciation
Book Value3379748BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2781530OtherCostOrOtherBasis
Depreciation568754Depreciation
Book Value2212776BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings12770917TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionDUE FROM AFFILIATED ORGDescription
Book Value6232592BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets6232592TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
ACCRUED BONUS$340,228
PENSION/BENEFIT PLAN PAYABLE$896,765
DUE TO AFFILIATES$13,148,099
LT DEFERRED RENT$745,903
SEVERENCE/POST EMPLOYMENT BENEFITS$5,495,302
FieldValueIRS element (for citing)
Total Of Amounts20626297TotalOfAmounts

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
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 PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)

Base 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
ARTHUR SOUTHAM MD
07413740117500007328500336623012064029979110688121
BERNARD TYSON
08926050129000006176910469158012994032824480587707
DEBORAH STOKES
0315132033757506759501050240129940838320048521
DONNA LYNNE
0476108047500003638090208108014839015378640323554
GERARD L COY
03522190260702013276008574901206408434940115894
KATHRYN LANCASTER
0630520090795305706290276632012994023987280529003
THOMAS R MEIER
03144710339188014858809780801299409130490113944
VICTORIA B ZATKIN
019267508569203640108257001961039929900
RUSS HEROLD
011975201603506349014151014839017112600
BARBARA ISHIKAWA
0163757057746015394022572014839027430800
MARK S ZEMELMAN
03985020259500012057401793380125850970499080051
DENNIS SENTZ
01749910842740793280106499012567045765900

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierExplanationExplanation
Schedule J, Question 3All officers, directors and employees performing services for Camp Bowie Service Center (CBSC) are employees of other Kaiser organizations. CBSC is recharged by other Kaiser organizations for employees' time. CBSC currently utilizes 342 employees of other Kaiser organizations. Camp bowie service center relied on a related organization that used one or more of the methods described below to establish the top management officials' compensation: Compensation committee Independent compensation consultant Written employment contract Compensation survey or study, and Approval by the board or compensation committee
Schedule J, Question 4aListed 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, Question 4bGerald L. Coy $ 115,894 Kathryn Lancaster 529,350 Thomas Meier 114,428 Deborah Stokes 48,521 Donna Lynne 323,554 Arthur M. Southam 688,121 Bernard J. Tyson 587,707 Mark S. Zemelman 81,133 TOTAL $2,488,708 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 O IRS990ScheduleO

General Explanation GeneralExplanation (24 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Line 6Kaiser Foundation Health Plan, Inc is sole member
Form 990, Part VI, Line 7aKaiser Foundation Health Plan, Inc appoints the directors (and fills vacancies and has authority to remove directors)
Form 990, Part VI, Line 7bThe single member, Kaiser Foundation Health Plan, Inc, could have approval over goveranance decisions.
Form 990, Part VI, Line 11bFORM 990 REVIEW PROCESS 1. KEY INFORMATION IS OBTAINED AND/OR CONFIRMED WITH INTERNAL SOURCES INCLUDING REGIONAL FINANCE AND EXECUTIVE COMPENSATION. 2. Prior to finalization, the return is reviewed with a PRICEWATERHOUSECOOPERS tax advisor. 3. once signed by a PRICEWATERHOUSECOOPERS tax advisor, the return and underlying data are reviewed by an officer or a member of management designated by an officer for signature and filing. 4. Copies are then provided to Board Members prior to filing.
Form 990, Part VI, Line 12cRegularly and Consistently Monitors Compliance with the Conflicts of Interest Policy Kaiser Permanente regularly monitors compliance with the Conflicts of Interest Policy in 3 key ways: 1. The Kaiser Permanente Compliance Hotline is available to all employees and vendors to report actual or potential conflicts of interest. All calls are answered by a third party and provided to Kaiser Permanente's National Compliance Office for review and appropriate action. Employees can report anonymously. Retaliation is prohibited. Reports of actual or potential Conflicts of Interest are generated and investigations are conducted as required and information is tracked and trended to determine if additional guidance is required to avoid or manage conflicts of interest. Compliance Hotline Reports are provided for review and action to the Kaiser Foundation Health Plan/ Hospitals Boards of Directors annually. 2. The Chief Compliance Officer and the SVP of Internal Audit Services annually review the directors', officers', key employees', and executives' Annual Conflicts of Interest Questionnaire disclosures and provide direction on any investigations required. Investigations are documented, tracked and trended to determine if additional controls or education is required; In addition, Conflicts of Interest Questionnaire reports are provided for review and action to the Kaiser Foundation Health Plan/ Hospitals Boards of Directors annually; and 3. Annually, as a component of the external audit, KPMG reviews the Annual Conflicts of Interest Questionnaires process completed by Directors, Officers, Key Employees, and Executives, and actions taken as a result of the disclosures. The results of the annual audit, including any findings in this area are presented to the Kaiser Foundation Health Plan/ Hospitals Audit and Compliance Committee. 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: A. Represented employees are subject to any corrective/disciplinary action provisions described in specific regional/national collective bargaining agreements and/or organizational policies and practices. B. 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. C. 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/bThe executive compensation program as administered by Kaiser Foundation Health Plan, Inc is designed to recruit, retain and motivate qualified senior management personnel. Senior management personnel have a significant impact on the strategic and policy direction and results of the organization. Therefore, the executive compensation program is, to a significant degree, performance-based. The compensation program is reviewed annually by the Compensation Committee of the Board of Directors which evaluates and approves, prior to payment, all programs and payments to CEO, Executive Director and top management officials (executives). Base pay for executive positions is established at a level comparable to the relevant market. In addition, other components of the compensation program bear 'at-risk' features designed to focus on strategically important performance goals and to assist in attracting and retaining top performers. The executive compensation program is targeted at the median of the comparable external market in which the organization competes for executive leadership. Evaluation of comparable pay data is performed by an Independent Compensation, Benefit & Human Resource Consulting firm. The compensation program focuses on objectives in the areas of quality of member care and service, financial soundness, and the community and social mission of the organization.
Form 990, Part VI, Line 19Governing documents, Conflict of Interest Policy - are available upon request as disclosed to other regulatory bodies To request copies contact: Vice President - National Tax Compliance Kaiser Foundation Health Plan and Hospitals One Kaiser Plaza, Ste 15L Oakland, CA 94612
Form 990, Part VII, Section A, Column BIndividuals 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.Hours for related organizations
Form 990, Part XI, Line 5Change in Other Comprehensive Income <$257,647>Other Changes in Net Assets or Fund Balances
Form 990, Part V, Line 2All officers, directors and employees performing services for Camp Bowie Service Center (CBSC) are employees of other Kaiser organizations. CBSC is recharged by other Kaiser organizations for employees' time. CBSC currently utilizes 342 employees of other Kaiser organizations.
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:ARTHUR SOUTHAM, MD TITLE:DIRECTOR HOURS:50FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:BERNARD TYSON TITLE:DIRECTOR HOURS:49FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:DONNA LYNNE TITLE:DIRECTOR & CHAIR HOURS:49FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:DEBORAH STOKES TITLE:SVP, CC & CAO HOURS:50FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:GERARD L COY TITLE:PRESIDENT HOURS:40FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:KATHRYN LANCASTER TITLE:EXECUTIVE VP, CFO HOURS:49FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:THOMAS R MEIER TITLE:SVP & TREASURER HOURS:49FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:VICTORIA B ZATKIN TITLE:ASSISTANT SECRETARY HOURS:50FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:MARK S. ZEMELMAN TITLE:SECRETARY HOURS:50FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:RUSS HEROLD TITLE:SR MANAGER ACCOUNTING HOURS:FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:CHARLES KIRSCHBAUM TITLE:SR OPERATIONS MANAGER HOURS:FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:CALVIN STRIGGLES TITLE:MANAGER - ACCOUNTING HOURS:FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:BARBARA ISHIKAWA TITLE:DIR - MEMBERSHIP ADMIN HOURS:FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:DENNIS SENTZ TITLE:CONTROLLER/MARKETING/SALES HOURS:30FORM 990 PART VII

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 INCfalse
KAISER FOUNDATION HEALTH PLAN OF GA INC
ONE KAISER PLAZA 15LOAKLAND CACA94612581592076HEALTH CAREGA501(c)(3)9KFHP INCfalse
KAISER FOUNDATION HEALTH PLAN OF THE NW
ONE KAISER PLAZA 15LOAKLANDCA94612930798039HEALTH CAREOR501(c)(3)9KFHP INCfalse
KAISER FOUNDATION HEALTH PLAN OF OH INC
ONE KAISER PLAZA 15LOAKLANDCA94612340922268HEALTH CAREOH501(c)(3)9KFHP INCfalse
KAISER FOUNDATION HOSPITALS
ONE KAISER PLAZA 15LOAKLANDCA94612941105628HEALTH CARECA501(c)(3)3KFHP INCfalse
KAISER FOUNDATION HEALTH PLAN OF THE MAS
ONE KAISER PLAZA 15LOAKLANDCA94612520954463HEALTH CAREMD501(c)(3)9KFHP INCfalse
KAISER HEALTH ALTERNATIVES
ONE KAISER PLAZA 15LOAKLANDCA94612930954562HEALTH CAREOR501(c)(3)9KFHP INCfalse
KAISER HOSPITAL ASSET MANAGEMENT INC
ONE KAISER PLAZA 15LOAKLANDCA94612943299125ASSET MGMTCA501(c)(3)11 - IKF HOSPITALSfalse
KAISER HEALTH PLAN ASSET MANAGEMENT INC
ONE KAISER PLAZA 15LOAKLANDCA94612943299124ASSET MGMTCA501(c)(3)11 - IKFHP INCfalse
LOKAHI ASSURANCE LTD
ONE KAISER PLAZA 15LOAKLANDCA94612912171891WC PlacementHI501(c)(3)11 - IKFHP INCfalse
OHP
ONE KAISER PLAZA 15LOAKLANDCA94612930480268LEASINGWA501(c)(3)11 - IKFHP INCfalse
1800 HARRISON FOUNDATION
ONE KAISER PLAZA 15LOAKLANDCA94612943317484FINANCINGCA501(c)(3)11 - IIKFHP INCfalse
KAISER HOSPITAL ASSISTANCE CORPORATION
ONE KAISER PLAZA 15LOAKLANDCA94612311779500FINANCINGCA501(c)(3)11 - IKF HOSPITALSfalse

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 AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
HEALTH CARE MANAGEMENT SOLUTIONS LLC
ONE KAISER PLAZA 15LOAKLANDCA94612203924985CONSULTINGCANAN/A000.00000
KAISER PERMANENTE VENTURES LLC
ONE KAISER PLAZA 15LOAKLANDCA94612272252521INVESTMENTSCANAN/A000.00000

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 AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
ARCHIMEDES INC
ONE KAISER PLAZA 15LOAKLANDCA94612203774729CONSULTINGCANAC CORP000.00000
KAISER PERMANENTE INTERNATIONAL
ONE KAISER PLAZA 15LOAKLANDCA94612943245176CONSULTINGCANAC CORP000.00000
KAISER PERMANENTE INSURANCE COMPANY
ONE KAISER PLAZA 15LOAKLANDCA94612943203402INSURANCECANAC CORP000.00000
KAISER PROPERTIES SERVICES INC
ONE KAISER PLAZA 15LOAKLANDCA94612943259432REAL ESTATECANAC CORP000.00000
OAK TREE ASSURANCE LTD
ONE KAISER PLAZA 15LOAKLANDCA94612030329760INSURANCEVTNAC CORP000.00000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
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 OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgtruePurchaseOfAssetsFromOtherOrg
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 EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg