SCAN HEALTH PLAN ARIZONA: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- SCAN HEALTH PLAN ARIZONA (EIN 73-1729007)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-15
- IRS object ID
- 201213209349302936
- Schema version
- 2011v1.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-15T10:59:37-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 861065772 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 655 WEST BROADWAY SUITE 700 | AddressLine1 |
| City | SAN DIEGO | City |
| State | CA | State |
| ZIP Code | 921018590 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 731729007 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SCAN HEALTH PLAN ARIZONA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SCAN | NameControl |
| Phone | 5629895100 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3800 KILROY AIRPORT WAY NO 100 | AddressLine1 |
| City | LONG BEACH | City |
| State | CA | State |
| ZIP Code | 908065616 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ELIZABETH RUSSELL | Name |
| Title | CEO | Title |
| Phone | 5629895100 | Phone |
| Date Signed | 2012-11-15 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DIANA J MCCUTCHEN | Name |
| PTIN | P00545657 | PTIN |
| Phone | 6192326500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | ELIZABETH RUSSELL | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3800 KILROY AIRPORT WAY NO 100 | AddressLine1 |
| City | LONG BEACH | City |
| State | CA | State |
| ZIP Code | 908065616 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 164282258 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.SCANHEALTHPLAN.COM/ARIZONA/MEDICARE/ | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2006 | YearFormation |
| State Legal Domicile | AZ | StateLegalDomicile |
| Activity Or Mission Description | TO SERVE AND TO IMPROVE THE LIVES OF THE FRAIL, ELDERLY AND DISABLED RESIDENTS OF ARIZONA. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 3 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 0 | NbrIndependentVotingMembers |
| Total Nbr Employees | 217 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 57916933 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 164040421 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 168653 | InvestmentIncomePriorYear |
| Investment Income Current Year | 241837 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 58085586 | TotalRevenuePriorYear |
| Total Revenue Current Year | 164282258 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 2026901 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 2851978 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 112927247 | OtherExpensePriorYear |
| Other Expenses Current Year | 158698955 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 114954148 | TotalExpensesPriorYear |
| Total Expenses Current Year | 161550933 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -56868562 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2731325 | RevenuesLessExpensesCY |
| Total Assets BOY | 33787805 | TotalAssetsBOY |
| Total Assets EOY | 68565984 | TotalAssetsEOY |
| Total Liabilities BOY | 59440555 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 91156327 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -25652750 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -22590343 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO SERVE AND IMPROVE THE LIVES OF THE FRAIL, ELDERLY AND DISABLED RESIDENTS OF ARIZONA BY PROVIDING MEDICAL AND PHARMACY SERVICES, COORDINATED CARE, SOCIAL SERVICES AND OTHER SERVICES TO A GERIATRIC AND DISABLED POPULATION THAT IS UNDERSERVED AND AT RISK. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 148876920 | Expense |
| Revenue | 164040421 | Revenue |
| Description | THE ARIZONA COMPANIES, SCAN HEALTH PLAN ARIZONA, A MEDICARE ADVANTAGE CONTRACTOR, AND SCAN LONG TERM CARE, A PROGRAM CONTRACTOR TO THE ARIZONA LONG TERM CARE SYSTEM (ALTCS) COMPONENT OF THE ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM (AHCCCS), THE STATE MEDICAID PROGRAM, ARE NON-PROFIT MANAGED CARE ORGANIZATIONS THAT WERE CREATED TO SERVE THE HEALTH CARE AND INDEPENDENCE NEEDS OF THE SENIOR AND PHYSICALLY DISABLED CITIZENS OF MARICOPA COUNTY, ARIZONA. THE SHARED MISSION OF THE ARIZONA COMPANIES IS TO FIND INNOVATIVE WAYS TO ENHANCE THE BENEFICIARIES' ABILITY TO MANAGE THEIR HEALTH AND EXERT CONTROL OVER WHERE AND HOW THEY LIVE. WE WILL ACHIEVE THAT MISSION BY DEVELOPING PARTNERSHIPS THAT ALLOW US TO DELIVER THE RIGHT HEALTH CARE, IN THE RIGHT SETTING, AND AT THE RIGHT COST WHILE MAXIMIZING THE MEMBERS' ABILITY TO REMAIN AS INDEPENDENT AS POSSIBLE. OUR GOAL IS TO BECOME THE LEADING GERIATRIC AND PHYSICALLY DISABLED HEALTH MANAGEMENT ENTERPRISE IN MARICOPA COUNTY.SCAN LONG TERM CARE WAS SELECTED AS AN ALTCS PROGRAM CONTRACTOR IN MAY, 2006 AND BEGAN PROGRAM OPERATIONS ON OCTOBER 1, 2006. THE PLAN IS RESPONSIBLE FOR ARRANGING, MANAGING AND MONITORING THE FULL RANGE OF HEALTH CARE SERVICES (PHYSICIAN, HOSPITAL, LAB, RADIOLOGY, DURABLE MEDICAL EQUIPMENT, ETC.), NOT OTHERWISE COVERED BY MEDICARE, HOME CARE SERVICES AND RESIDENTIAL CARE SERVICES REQUIRED BY THE ALTCS BENEFICIARIES ENROLLED IN SCAN. THE ALTCS PROGRAM IS DESIGNED TO SERVE THE NEEDS OF LOW INCOME ARIZONA CITIZENS AGE 65 OR OLDER, BLIND OR DISABLED AND IN NEED OF LONG TERM CARE SERVICES. THE ENROLLMENT OF PARTICIPANTS IN THE COMPANY'S MANAGED CARE PLAN INITIALLY BEGAN ON OCTOBER 1, 2006; THE CONTRACT WAS NOT RENEWED FOR THE NEW CONTRACT YEAR, WHICH BEGAN OCTOBER 1, 2011. THE COMPANY CONTINUED TO PARTICIPATE IN THE ALTCS PROGRAM ON A CAPPED CONTRACT BASIS. ON DECEMBER 22, 2011, THE COMPANY PROVIDED WRITTEN NOTICE TO AHCCCS TERMINATING THE ALTCS PROGRAM CONTRACT. ON JANUARY 23, 2012, AHCCCS NOTIFIED THE COMPANY THAT THE TERMINATION WOULD BE EFFECTIVE MAY 1, 2012. IT IS THE COMPANY'S INTENT TO SUSTAIN POSITIVE WORKING CAPITAL AND LIQUIDITY TO MEET ALL FINANCIAL OBLIGATIONS THROUGHOUT THE TRANSITION PERIOD TO CONCLUDE THE PROGRAM.SCAN HEALTH PLAN ARIZONA BEGAN PROGRAM OPERATIONS AS A MEDICARE ADVANTAGE CONTRACTOR EFFECTIVE JANUARY 1, 2007. IT IS RESPONSIBLE FOR ARRANGING AND MONITORING THE FULL RANGE OF MEDICARE HEALTH SERVICES FOR PLAN ENROLLEES. THE PLAN BEGAN OFFERING A MEDICARE ADVANTAGE SPECIAL NEEDS PLAN (SNP) FOR BENEFICIARIES WHO ARE DUALLY ELIGIBLE AND ENROLLED IN BOTH THE MEDICARE AND ALTCS PROGRAMS. BEGINNING JANUARY 1, 2009, THE PLAN EXPANDED ITS MEDICARE ADVANTAGE PARTICIPATION TO OTHER MEDICARE BENEFICIARY POPULATIONS, THROUGH A MEDICARE ADVANTAGE PRESCRIPTION DRUG (MAPD) PLAN.IN JANUARY 2008 THE ARIZONA COMPANIES LAUNCHED THE SCAN CONNECTIONS COMMUNITY RESOURCE CENTER DESIGNED TO LINK SCAN MEMBERS, THEIR CAREGIVERS AND OTHERS IN THE MARICOPA COUNTY COMMUNITIES WITH KNOWLEDGEABLE STAFF WHO CAN ASSIST IN NAVIGATING A COMPLEX HEALTH CARE SYSTEM. THE RESOURCE CENTER STAFF BUILD BRIDGES INTO OTHER COMMUNITY ORGANIZATIONS, GOVERNMENTAL AGENCIES AND HEALTH ADVOCACY GROUPS TO PROVIDE TO THE COMMUNITY HEALTH EDUCATION AND SUPPORT SERVICES FOCUSED ON GERIATRIC, CHRONIC ILLNESS AND PHYSICALLY DISABLED CHALLENGES. SERVICES AND RESOURCES ARE PROVIDED AT THE SCAN CONNECTIONS RESOURCE CENTER IN SCAN'S OFFICE AND AT REMOTE COMMUNITY SITES.SCAN HEALTH PLAN ARIZONA HAS GROWN FROM NO MEMBERSHIP AT DECEMBER 31, 2006 AND CURRENTLY SERVES MORE THAN 13,936 ENROLLEES. THE ADDITION OF THE SCAN CLASSIC AND SCAN CONNECTIONS PROGRAMS ALLOW SCAN PERSONNEL, ESPECIALLY THE CASE MANAGEMENT TEAM, TO MORE EFFECTIVELY COORDINATE THE NEEDED HEALTH CARE SERVICES REQUIRED BY SCAN MEMBERS. FROM THE START OF OPERATIONS, THE ARIZONA COMPANIES HAVE DEVOTED NEARLY 98% OF ITS REVENUE TO THE DIRECT PROVISION OF HEALTH CARE, HOME AND COMMUNITY BASED SERVICES AND LONG TERM CARE RESIDENTIAL SERVICES. THIS REPRESENTS MORE THAN $769 MILLION OF DIRECT CARE SERVICES FOR THESE MEDICARE AND MEDICAID ENROLLEES. OF THE TOTAL AMOUNT PAID FOR MEDICAL AND RESIDENTIAL SERVICES, APPROXIMATELY 33.9% WAS DIRECTED TO LONG TERM CARE RESIDENTIAL SERVICE PROVIDERS, 21.3% WAS DIRECTED TO HOME AND COMMUNITY BASED SERVICE PROVIDERS, AND 42.1% WAS DIRECTED TO OTHER MEDICAL SERVICE PROVIDERS AND THE REMAINING 2.6% WAS DIRECTED TO CASE MANAGEMENT COORDINATION SERVICES. | Description |
| Total Program Service Expense | 148876920 | TotalProgramServiceExpense |
| Described In501 C3 | 0 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 2457 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 217 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 3 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 0 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | AZ | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VIRGINIA HAVAI | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5629895100 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3800 KILROY AIRPORT WAY | AddressLine1 |
| City | LONG BEACH | City |
| State | CA | State |
| ZIP Code | 90806 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (16 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| ELIZABETH RUSSELL | |||||||||
| CHIEF EXECUTIVE OFFICER | 5.00 | X | X | 0 | 487331 | 81495 | |||
| DENNIS EDER | |||||||||
| OUTGOING DIRECTOR | 0.40 | X | 0 | 1322329 | 31361 | ||||
| RYAN TRIMBLE | |||||||||
| DIRECTOR | 0.40 | X | 0 | 921522 | 10976 | ||||
| DOUGLAS JAQUES | |||||||||
| DIRECTOR,SECRETARY | 5.00 | X | X | 0 | 416260 | 79903 | |||
| RANDY STONE | |||||||||
| CHIEF FINANCIAL OFFICER | 5.00 | X | 0 | 226899 | 15107 | ||||
| DAVE FIRDAUS | |||||||||
| CHIEF OPERATING OFFICER | 5.00 | X | 144474 | 0 | 7647 | ||||
| RAJEEV NARULA | |||||||||
| OUTGOING CHIEF FINANCIAL OFFICER | 5.00 | X | 0 | 301809 | 41528 | ||||
| REBECCA LEARNER | |||||||||
| SR. VP COMPLIANCE | 5.00 | 0 | 299150 | 40739 | X | ||||
| MAUREEN MCGUIRRIN | |||||||||
| OUTGOING VP OPERATIONS | 40.00 | 395905 | 0 | 24174 | X | ||||
| GILBERT MILLER | |||||||||
| SR. VP NATIONAL SALES | 40.00 | 0 | 257055 | 486 | X | ||||
| THOMAS HOEHNER | |||||||||
| VICE PRESIDENT, NETWORK MANAGEMENT | 40.00 | 275777 | 0 | 11356 | X | ||||
| MARTIN GIBSON | |||||||||
| CHIEF ACTUARY | 40.00 | 0 | 211517 | 26058 | X | ||||
| JOEY ZEPEDA | |||||||||
| VP CASE MANAGEMENT | 40.00 | 185256 | 0 | 35729 | X | ||||
| RICHARD PEITZMEIER | |||||||||
| VP MEMBERSHIP SALES | 40.00 | 152900 | 0 | 19643 | X | ||||
| TINA GRAHAM | |||||||||
| VP COMPLIANCE | 40.00 | 182913 | 0 | 13324 | X | ||||
| THOMAS LESCAULT | |||||||||
| FORMER PRESIDENT | 0.00 | 252671 | 0 | 11809 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1589896 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 4443872 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 451335 | TotalOtherCompensation |
| Number Individuals GT100 K | 10 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| EXPRESS SCRIPTS INC | |||||
| 21653 NETWORK PLACE | CHICAGO | IL | 606731216 | MEDICAL SERVICES | 24249466 |
| JOHN C LINCOLN NORTH MOUNTAIN HOSPITAL | |||||
| 250 E DUNLAP AVENUE | PHOENIX | AZ | 85020 | MEDICAL SERVICES | 6123207 |
| BANNER BOSWELL MEDICAL CENTER | |||||
| PO BOX 29693 | PHOENIX | AZ | 850389693 | MEDICAL SERVICES | 4706535 |
| SCOTTSDALE HEALTHCARE HOSPITAL | |||||
| PO BOX 29682 | PHOENIX | AZ | 850389682 | MEDICAL SERVICES | 4433522 |
| BANNER BAYWOOD MEDICAL CENTER | |||||
| POBOX 2978 | PHOENIX | AZ | 85062 | MEDICAL SERVICES | 4359394 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 182 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| MEDICARE PREMIUM | 900099 | 137285759 | 137285759 |
| PREMIUM RESERVE | 900099 | 26754662 | 26754662 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 164040421 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 241837 | TotalRevenueColumn |
| Exclusion | $241,837 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 164282258 | TotalRevenueColumn |
| Related Or Exempt Function Income | 164040421 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $241,837 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 161164 | Total |
| Management And General | 161164 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2169558 | Total |
| Program Services | 1058343 | ProgramServices |
| Management And General | 1111215 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 98606 | Total |
| Program Services | 41038 | ProgramServices |
| Management And General | 57568 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 241299 | Total |
| Program Services | 92816 | ProgramServices |
| Management And General | 148483 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 181351 | Total |
| Program Services | 80847 | ProgramServices |
| Management And General | 100504 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4808208 | Total |
| Program Services | 776059 | ProgramServices |
| Management And General | 4032149 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 29186 | Total |
| Management And General | 29186 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 102488 | Total |
| Management And General | 102488 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6852816 | Total |
| Program Services | 1357102 | ProgramServices |
| Management And General | 5495714 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 831637 | Total |
| Program Services | 1471 | ProgramServices |
| Management And General | 830166 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 97062 | Total |
| Program Services | 7808 | ProgramServices |
| Management And General | 89254 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14966 | Total |
| Program Services | 5673 | ProgramServices |
| Management And General | 9293 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 107806 | Total |
| Management And General | 107806 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 113378 | Total |
| Program Services | 9576 | ProgramServices |
| Management And General | 103802 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13987 | Total |
| Program Services | 1460 | ProgramServices |
| Management And General | 12527 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 70031 | Total |
| Program Services | 35793 | ProgramServices |
| Management And General | 34238 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| MEDICAL SERVICES FOR EL | 145392371 | 145392371 | 0 | 0 |
| MANAGEMENT RECRUITMENT | 142608 | 0 | 142608 | 0 |
| OFFICE EQUIPMENTS | 45585 | 5502 | 40083 | 0 |
| TELECOMMUNICATIONS | 33370 | 7441 | 25929 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43456 | Total |
| Program Services | 3620 | ProgramServices |
| Management And General | 39836 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 161550933 | Total |
| Program Services | 148876920 | ProgramServices |
| Management And General | 12674013 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24996948 | BOY |
| EOY | 57821209 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14253 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1307583 | BOY |
| EOY | 3990162 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 62594 | BOY |
| EOY | 38920 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1951596 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1613388 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 700165 | BOY |
| EOY | 338208 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5113886 | BOY |
| EOY | 5125006 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1592376 | BOY |
| EOY | 1252479 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33787805 | BOY |
| EOY | 68565984 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 59042786 | BOY |
| EOY | 40320084 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 105152 | BOY |
| EOY | 509309 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 292617 | BOY |
| EOY | 50326934 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 59440555 | BOY |
| EOY | 91156327 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -25652750 | BOY |
| EOY | -22590343 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -25652750 | BOY |
| EOY | -22590343 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33787805 | BOY |
| EOY | 68565984 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 2731325 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 331082 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 883637 | OtherCostOrOtherBasis |
| Depreciation | 785856 | Depreciation |
| Book Value | 97781 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1067959 | OtherCostOrOtherBasis |
| Depreciation | 827532 | Depreciation |
| Book Value | 240427 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 338208 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (2 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| INVESTMENT IN SCAN LONG TERM CARE | 3500000 | C |
| OTHER RESTRICTED INVESTEMENTS | 1625006 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 5125006 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DEFERRED COMPENSATION | $326,934 |
| SURPLUS NOTE PAYABLE | $50,000,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 50326934 | TotalOfAmounts |
| Total Revenue | 164282258 | TotalRevenue |
| Total Expenses | 161550933 | TotalExpenses |
| Excess Or Deficit For Year | 2731325 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -25918 | NetUnrealizedGLOnInvestments |
| Other | $357,000 | OtherAmount |
| Total Adjustments | 331082 | TotalAdjustments |
| Excess Or Deficit Per FS | 3062407 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 137501679 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -25917 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | -25917 | RevenueNotRptdF990 |
| Revenue Subtotal | 137527596 | RevenueSubtotal |
| Other Revenues Not Included | 26754662 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 26754662 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 164282258 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 134797160 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 889 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 889 | ExpensesNotRptdF990 |
| Expenses Subtotal | 134796271 | ExpensesSubtotal |
| Other Expenses Not Included | 26754662 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 26754662 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 161550933 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | FIN 48 (ASC 740) WAS ADOPTED BY THE ORGANIZATION DURING THE YEAR ENDED DECEMBER 31, 2009. THERE HAS BEEN NO LIABILITY FOR UNCERTAIN TAX POSITIONS RECORDED ON THE FINANCIAL STATEMENTS FOR THE CURRENT YEAR. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | 2010 AUDIT ADJUSTMENT 357,000. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | PREMIUM RESERVE 26,754,662. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | DIFFERENCE IN ADMINISTRATIVE EXPENSES 889. | |
| PART XIII, LINE 4B - OTHER ADJUSTMENTS: | PREMIUM RESERVE 26,754,662. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 1 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (16 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ELIZABETH RUSSELL | |||||||||||||
| 0 | 315649 | 0 | 150000 | 0 | 21682 | 0 | 52323 | 0 | 29172 | 0 | 568826 | 0 | 0 |
| DENNIS EDER | |||||||||||||
| 0 | 141030 | 0 | 102983 | 0 | 1078316 | 0 | 19682 | 0 | 11679 | 0 | 1353690 | 0 | 228326 |
| RYAN TRIMBLE | |||||||||||||
| 0 | 566191 | 0 | 350000 | 0 | 5331 | 0 | 0 | 0 | 10976 | 0 | 932498 | 0 | 0 |
| DOUGLAS JAQUES | |||||||||||||
| 0 | 292404 | 0 | 105783 | 0 | 18073 | 0 | 42184 | 0 | 37719 | 0 | 496163 | 0 | 0 |
| RANDY STONE | |||||||||||||
| 0 | 207618 | 0 | 0 | 0 | 19281 | 0 | 2334 | 0 | 12773 | 0 | 242006 | 0 | 0 |
| DAVE FIRDAUS | |||||||||||||
| 91182 | 0 | 46048 | 0 | 7244 | 0 | 0 | 0 | 7647 | 0 | 152121 | 0 | 0 | 0 |
| RAJEEV NARULA | |||||||||||||
| 0 | 232725 | 0 | 53007 | 0 | 16077 | 0 | 17150 | 0 | 24378 | 0 | 343337 | 0 | 0 |
| REBECCA LEARNER | |||||||||||||
| 0 | 222074 | 0 | 59855 | 0 | 17221 | 0 | 24672 | 0 | 16067 | 0 | 339889 | 0 | 0 |
| MAUREEN MCGUIRRIN | |||||||||||||
| 162722 | 0 | 39558 | 0 | 193625 | 0 | 17150 | 0 | 7024 | 0 | 420079 | 0 | 0 | 0 |
| GILBERT MILLER | |||||||||||||
| 0 | 80739 | 0 | 0 | 0 | 176316 | 0 | 0 | 0 | 486 | 0 | 257541 | 0 | 0 |
| THOMAS HOEHNER | |||||||||||||
| 136134 | 0 | 15291 | 0 | 124352 | 0 | 7314 | 0 | 4042 | 0 | 287133 | 0 | 0 | 0 |
| MARTIN GIBSON | |||||||||||||
| 0 | 153230 | 0 | 33494 | 0 | 24793 | 0 | 14244 | 0 | 11814 | 0 | 237575 | 0 | 0 |
| JOEY ZEPEDA | |||||||||||||
| 148757 | 0 | 26826 | 0 | 9673 | 0 | 12990 | 0 | 22739 | 0 | 220985 | 0 | 0 | 0 |
| RICHARD PEITZMEIER | |||||||||||||
| 137169 | 0 | 12446 | 0 | 3285 | 0 | 10692 | 0 | 8951 | 0 | 172543 | 0 | 0 | 0 |
| TINA GRAHAM | |||||||||||||
| 140944 | 0 | 32790 | 0 | 9179 | 0 | 12167 | 0 | 1157 | 0 | 196237 | 0 | 0 | 0 |
| THOMAS LESCAULT | |||||||||||||
| 0 | 0 | 0 | 0 | 252671 | 0 | 11809 | 0 | 0 | 0 | 264480 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 3 | COMPENSATION FOR THE CEO WAS ESTABLISHED AND PAID BY A RELATED ORGANIZATION. THE RELATED ORGANIZATION USED THE FOLLOWING TO ESTABLISH THE CEO'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) FORM 990 OF OTHER ORGANIZATIONS; (4) WRITTEN EMPLOYMENT CONTRACTS; (5) COMPENSATION SURVEY OR STUDY; (6) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| PART I, LINES 4A-C | PART I, LINES 4A-C: 4A: DURING 2011, THE EMPLOYMENT RELATIONSHIPS OF THE FOLLOWING HIGHEST COMPENSATED EMPLOYEE'S, KEY EMPLOYEE'S AND OFFICER'S, WITH SCAN HEALTH PLAN, SCAN GROUP AND SCAN HEALTH PLAN ARIZONA WERE ENDED. IN CONNECTION WITH THE TERMINATION OF THEIR EMPLOYMENTS, SCAN HEALTH PLAN NEGOTIATED AND PAID SEVERANCE TO EACH OF THEM. THE SEVERANCE PAYMENT WAS IN ACCORDANCE WITH THE TERMS OF EACH HIGHEST COMPENSATED EMPLOYEE'S, KEY EMPLOYEE'S AND THE OFFICER'S THEN EXISTING EMPLOYMENT AGREEMENT. DENNIS EDER, CHIEF FINANCIAL OFFICER, OFFICER - SCAN HEALTH PLAN, $773,525 THOMAS LESCAULT, FORMER PRESIDENT - SCAN HEALTH PLAN ARIZONA, $236,171 THOMAS HOEHNER, HIGHLY COMPENSATED EMPLOYEE - SCAN HEALTH PLAN ARIZONA, $100,385 MAUREEN MCGUIRRIN, VP OF OPERATIONS, KEY EMPLOYEE - SCAN HEALTH PLAN ARIZONA, $146,596 4B: THE COMPANY PROVIDES A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN TO ONLY SENIOR EXECUTIVES OF THE COMPANY. SENIOR V.P. AND OFFICERS ARE ELIGIBLE TO PARTICIPATE IN THE SECTION 457(F) PLAN. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE COMPANY'S SECTION 457(F) DURING THE YEAR 2011: RANDY STONE, DENNIS EDER, DOUGLAS JAQUES, REBECCA LEARNER AND ELIZABETH RUSSELL. COMPENSATION PURSUANT TO THE TERMS AND CONDITIONS OF THE SECTION 457(F) PLAN, A PARTICIPANT BECOMES 100% VESTED IN THE EMPLOYER CONTRIBUTION UPON THE OCCURRENCE OF ANY OF THE FOLLOWING WHILE THE PARTICIPANT IS AN EMPLOYEE: (I) THE PARTICIPANT HAS TEN YEARS OF CONTINUOUS EMPLOYMENT, COUNTING ONLY SERVICE AFTER DECEMBER 31, 2005; (II) THE PARTICIPANT REACHES THE AGE OF 62 AND HAS FIVE YEARS OF CONTINUOUS EMPLOYMENT; (III) THE PARTICIPANT'S INVOLUNTARY TERMINATION; (IV) THE PARTICIPANT'S DISABILITY; OR (V) THE PARTICIPANT'S DEATH. THERE WAS 1 INDIVIDUAL WHO RECEIVED PAYMENTS OUT OF THE SECTION 457(F) PLAN DURING THE YEAR: DENIS EDER, $228,326. 4C: THE FOLLOWING INDIVIDUAL PARTICIPATED IN SCAN HEALTH PLAN'S KEYSOP PLAN DURING THE TAXABLE YEAR: REBECCA LEARNER. THE PLAN IS NOW FROZEN AND NO EMPLOYEES ARE BEING NEWLY ADDED AS PARTICIPANTS. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE ORGANIZATION IS SCAN GROUP, A CALIFORNIA NONPROFIT CORPORATION. | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE MEMBER HAS THE POWER TO APPOINT THE MEMBERS OF THE BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS PREPARED BY DELOITTE TAX LLP, WORKING IN CONJUNCTION WITH SCAN'S FINANCE DEPARTMENT. SCAN HEALTH PLAN'S ACCOUNTING MANAGER HAS DIRECT RESPONSIBILITY FOR THIS EFFORT, SUBJECT TO SUPERVISION BY THE SCAN HEALTH PLAN ARIZONA'S CHIEF FINANCIAL OFFICER. AFTER AN INITIAL DRAFT OF THE FORM 990 IS PREPARED, IT IS CIRCULATED FOR REVIEW AND COMMENT BY RELEVANT MEMBERS OF THE EXECUTIVE TEAM WHO HAVE RESPONSIBILITY AND/OR KNOWLEDGE ABOUT THE VARIOUS MATTERS DISCLOSED AND/OR DESCRIBED IN THE FORM. THE GENERAL COUNSEL, IN PARTICULAR, REVIEWS THE FORM 990 AND ENSURES ACCURACY OF DESCRIPTIONS AND THAT DISCLOSURE IS COMPLETE. THE DRAFT FORM 990 IS REVIEWED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS OF SCAN GROUP, AND IS SHARED WITH ALL MEMBERS OF THE BOARD OF DIRECTORS AFTER IT IS READY FOR FILING BUT BEFORE IT IS FILED. | |
| FORM 990, PART VI, SECTION B, LINE 12C | SCAN HEALTH PLAN ARIZONA REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY THROUGH ANNUAL CIRCULATION OF A CONFLICT OF INTEREST QUESTIONNAIRE WHICH IS REQUIRED TO BE ANSWERED BY ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS AND MEMBERS OF EXECUTIVE MANAGEMENT. IN ADDITION, THERE IS REGULAR EDUCATION AND ENFORCEMENT THROUGH OVERSIGHT OF SUCH POLICY AND THE SCAN HEALTH PLAN ARIZONA GIFT AND BUSINESS COURTESIES POLICY WITH RESPECT TO EACH DEPARTMENT BY MEMBERS OF THE SENIOR EXECUTIVE TEAM WITH RESPONSIBILITY FOR SUCH DEPARTMENT. THE LEGAL DEPARTMENT OF SCAN GROUP REVIEWS ALL CONTRACTUAL RELATIONSHIPS ENTERED INTO BY THE ORGANIZATION AND THE GENERAL COUNSEL OF SCAN GROUP IS RESPONSIBLE FOR MONITORING CONFLICTS OF INTEREST THROUGH THE ANNUAL CIRCULATION AND REVIEW OF THE CONFLICT OF INTEREST QUESTIONNAIRE. ACCORDINGLY, THE LEGAL DEPARTMENT OF SCAN GROUP THROUGH THE GENERAL COUNSEL IS IN A POSITION TO MONITOR AND ENFORCE COMPLIANCE WITH THE POLICY ON AN ONGOING BASIS. | |
| FORM 990, PART VI, SECTION B, LINE 15 | 15A: THE PROCESS FOR DETERMINING THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER OF SCAN HEALTH PLAN ARIZONA IS CONDUCTED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF SCAN GROUP, ALL OF THE VOTING MEMBERS OF WHICH ARE INDEPENDENT PERSONS. IN DETERMINING THE CEO'S COMPENSATION, THE COMPENSATION COMMITTEE WORKS WITH AND RELIES UPON THE COUNSEL AND EXPERTISE OF ERNST & YOUNG, A CONSULTANT WITH WELL-ESTABLISHED EXPERIENCE AND EXPERTISE IN THE AREA OF NONPROFIT ORGANIZATION EXECUTIVE COMPENSATION AND COMPLIANCE WITH THE INTERMEDIATE SANCTIONS REQUIREMENTS APPLICABLE TO SUCH COMPENSATION. ERNST & YOUNG PROVIDES AN "EXECUTIVE COMPENSATION REPORT" TO THE COMPENSATION COMMITTEE EACH YEAR WHICH FURNISHES THE BASIS FOR THE ESTABLISHMENT OF THE CEO'S COMPENSATION PACKAGE DURING THE FOLLOWING YEAR. THE ERNST & YOUNG EXECUTIVE COMPENSATION REPORT IS BASED ON A REVIEW OF THE EXECUTIVE COMPENSATION PRACTICES OF A VARIETY OF ORGANIZATIONS THAT ARE CONSIDERED COMPARABLE TO SCAN HEALTH PLAN ARIZONA BASED ON VARIOUS METRICS. THE COMPENSATION COMMITTEE DELIBERATES ON THE ISSUE OF THE CEO'S COMPENSATION PACKAGE IN LIGHT OF THE ERNST & YOUNG EXECUTIVE COMPENSATION REPORT AND QUESTIONS ARE ASKED OF, AND ANSWERED BY ERNST & YOUNG, REGARDING SUCH REPORT AND OTHER MATTERS RELEVANT TO SUCH PACKAGE. BASED ON SUCH DELIBERATIONS, THE COMPENSATION COMMITTEE MAKES A RECOMMENDATION TO THE BOARD OF DIRECTORS OF SCAN HEALTH PLAN ARIZONA REGARDING THE COMPENSATION PACKAGE FOR THE FOLLOWING YEAR. THE BOARD OF DIRECTORS OF SCAN HEALTH PLAN ARIZONA DELIBERATES ON AND THEN VOTES ON SUCH RECOMMENDATION; THE CEO IS RECUSED FOR THE ENTIRETY OF SUCH DELIBERATIONS AND VOTE. THE MINUTES OF THE COMPENSATION FOR THESE MEETINGS ARE PREPARED SUBSTANTIALLY CONTEMPORANEOUSLY AND SUBSTANTIATE SUCH DELIBERATIONS AND DECISIONS. 15B: THE PROCESS FOR DETERMINING THE COMPENSATION OF OFFICERS OR OTHER KEY EMPLOYEES OF SCAN HEALTH PLAN ARIZONA IS CONDUCTED BY THE HUMAN RESOURCES DEPARTMENT AND CEO. IN DETERMINING SUCH EMPLOYEE'S COMPENSATION, THE HUMAN RESOURCES DEPARTMENT WORKS WITH AND RELIES UPON THE COUNSEL AND EXPERTISE OF ERNST & YOUNG, A CONSULTANT WITH WELL-ESTABLISHED EXPERIENCE AND EXPERTISE IN THE AREA OF NONPROFIT ORGANIZATION EXECUTIVE COMPENSATION AND COMPLIANCE WITH THE INTERMEDIATE SANCTIONS REQUIREMENTS APPLICABLE TO SUCH COMPENSATION. ERNST & YOUNG PROVIDES AN "EXECUTIVE COMPENSATION REPORT" TO THE HUMAN RESOURCES DEPARTMENT EACH YEAR WHICH FURNISHES THE BASIS FOR THE ESTABLISHMENT OF SUCH EMPLOYEES' COMPENSATION PACKAGE DURING THE FOLLOWING YEAR. THE ERNST & YOUNG EXECUTIVE COMPENSATION REPORT IS BASED ON A REVIEW OF THE EXECUTIVE COMPENSATION PRACTICES OF A VARIETY OF ORGANIZATIONS THAT ARE CONSIDERED COMPARABLE TO SCAN HEALTH PLAN ARIZONA BASED ON VARIOUS METRICS. | |
| FORM 990, PART VI, SECTION C, LINE 19 | SCAN HEALTH PLAN ARIZONA'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. SCAN HEALTH PLAN ARIZONA'S AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE FROM THE ARIZONA DEPARTMENT OF INSURANCE FOR A NOMINAL FEE. | |
| FORM 990, PART VII: | AVG HOURS DEVOTED TO RELATED ORGANIZATION(S) WHEN RELATED COMP IS REPORTED: PART VII, SECTION A, COLUMN D REPORTS COMPENSATION PAID BY SCAN HEALTH PLAN ARIZONA FOR SERVICES PROVIDED TO SCAN HEALTH PLAN ARIZONA AND AFFILIATES. COLUMN B INCLUDES TOTAL HOURS FOR BOTH SCAN HEALTH PLAN ARIZONA AND SCAN LONG TERM CARE. BELOW IS A BREAKDOWN OF HOURS SPENT PER AFFILIATE. SCAN HEALTH PLAN AND SCAN GROUP ARE OPERATED JOINTLY. THEREFORE, THE FOLLOWING INDIVIDUALS REPORTED ABOVE SPEND AN AVERAGE OF 40 HOURS PER WEEK BETWEEN THE TWO ORGANIZATIONS, AND THEREFORE ARE REPORTED AS WORKING 40 HOURS PER WEEK FOR EACH: DENNIS EDER DOUGLAS JAQUES RANDY STONE GILBERT MILLER REBECCA LEARNER ELIZABETH RUSSELL RYAN TRIMBLE RAJEEV NARULA (NOT INCLUDED ON PART VII FOR SCAN GROUP) THE FOLLOWING OFFICERS, KEY EMPLOYEES, AND BOARD MEMBERS OF SCAN HEALTH PLAN ARIZONA ALSO DEVOTE THE FOLLOWING TIME TO SCAN FOUNDATION: DENNIS EDER - 2.0 HOURS PER WEEK DOUGLAS JAQUES - 2.0 HOURS PER WEEK RANDY STONE - 2.0 HOURS PER WEEK RYAN TRIMBLE - 1.0 HOURS PER WEEK THE 40 HOURS PER WEEK DISCLOSED IN COLUMN B FOR MAUREEN MCGURRIN, TINA GRAHAM, JOEY ZEPEDA AND THOMAS HOEHNER ARE SPLIT BETWEEN SCAN HEALTH PLAN ARIZONA AND SCAN LONG TERM CARE. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -25,918. 2010 AUDIT ADJUSTMENT 357,000. TOTAL TO FORM 990, PART XI, LINE 5: 331,082. | CHANGES IN NET ASSETS OR FUND BALANCES: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| SCAN GROUP | |||||||||||
| 3800 KILROY AIRPORT WAY | LONG BEACH | CA | 90806 | 953826037 | ADMIN. SUPPORT | CA | 501(C)(3) | LINE 11, TYPE II: 50 | N/A | 0 | |
| SCAN HEALTH PLAN | |||||||||||
| 3800 KILROY AIRPORT WAY | LONG BEACH | CA | 90806 | 953858259 | MEDICARE ADVANTAGE | CA | 501(C)(3) | LINE 9 | 1 | SCAN GROUP | |
| SCAN LONG TERM CARE | |||||||||||
| 3800 KILROY AIRPORT WAY | LONG BEACH | CA | 90806 | 204607594 | MEDICAID MANAGEMENT CARE | AZ | 501(C)(4) | 1 | SCAN HEALTH PLAN ARIZONA | ||
| THE SCAN FOUNDATION | |||||||||||
| 3800 KILROY AIRPORT WAY | LONG BEACH | CA | 90806 | 450552845 | GRANT MAKING | CA | 501(C)(3) | LINE 11, TYPE II: 50 | 1 | SCAN HEALTH PLAN | |
| (no name) | |||||||||||
| 1 | |||||||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| SCAN LONG TERM CARE | ||
| P | 20508 | SEE PART VII |
| SCAN HEALTH PLAN | ||
| O | 2413913 | SEE PART VII |
| SCAN GROUP | ||
| O | 2394294 | SEE PART VII |
| SCAN LONG TERM CARE | ||
| N | 11209244 | SEE PART VII |
| SCAN LONG TERM CARE | ||
| M | 905463 | SEE PART VII |
| SCAN HEALTH PLAN | ||
| E | 50000000 | SEE PART VII |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | SCHEDULE R, PART V: | ReturnReference |
| Explanation | THE PERCENTAGE OF ALLOCATION TO AFFILIATED COMPANIES IS DETERMINED BASED ON ESTIMATED PERCENTAGE OF TIME WORKED, PERCENTAGE OF HEADCOUNTS, AND THE PERCENTAGE OF SCAN MEMBERSHIP, AS APPROPRIATE BASED ON THE NATURE OF THE EXPENSE. SCAN HEALTH PLAN ARIZONA RECEIVED A $50 MILLION SURPLUS NOTE FROM SCAN HEALTH PLAN, IN ORDER TO MEET CERTAIN CAPITAL REQUIREMENTS. THE NOTE WAS APPROVED BY THE ARIZONA DEPARTMENT OF INSURANCE AND THE CALIFORNIA DEPARTMENT OF MANAGED HEALTHCARE. | Explanation |