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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

FieldValueIRS element (for citing)
Timestamp2012-11-15T10:59:37-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN861065772EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DELOITTE TAX LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1655 WEST BROADWAY SUITE 700AddressLine1
CitySAN DIEGOCity
StateCAState
ZIP Code921018590ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN731729007EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SCAN HEALTH PLAN ARIZONABusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSCANNameControl
Phone5629895100Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line13800 KILROY AIRPORT WAY NO 100AddressLine1
CityLONG BEACHCity
StateCAState
ZIP Code908065616ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameELIZABETH RUSSELLName
TitleCEOTitle
Phone5629895100Phone
Date Signed2012-11-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDIANA J MCCUTCHENName
PTINP00545657PTIN
Phone6192326500Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonELIZABETH RUSSELLNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line13800 KILROY AIRPORT WAY NO 100AddressLine1
CityLONG BEACHCity
StateCAState
ZIP Code908065616ZIPCode
FieldValueIRS element (for citing)
Gross Receipts164282258GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.SCANHEALTHPLAN.COM/ARIZONA/MEDICARE/WebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2006YearFormation
State Legal DomicileAZStateLegalDomicile
Activity Or Mission DescriptionTO SERVE AND TO IMPROVE THE LIVES OF THE FRAIL, ELDERLY AND DISABLED RESIDENTS OF ARIZONA.ActivityOrMissionDescription
Nbr Voting Members Governing Body3NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees217TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year57916933ProgramServiceRevenuePriorYear
Program Service Revenue CY164040421ProgramServiceRevenueCY
Investment Income Prior Year168653InvestmentIncomePriorYear
Investment Income Current Year241837InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year58085586TotalRevenuePriorYear
Total Revenue Current Year164282258TotalRevenueCurrentYear
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 Year2026901SalariesEtcPriorYear
Salaries Etc Current Year2851978SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year112927247OtherExpensePriorYear
Other Expenses Current Year158698955OtherExpensesCurrentYear
Total Expenses Prior Year114954148TotalExpensesPriorYear
Total Expenses Current Year161550933TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-56868562RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2731325RevenuesLessExpensesCY
Total Assets BOY33787805TotalAssetsBOY
Total Assets EOY68565984TotalAssetsEOY
Total Liabilities BOY59440555TotalLiabilitiesBOY
Total Liabilities EOY91156327TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-25652750NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-22590343NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO 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 Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense148876920Expense
Revenue164040421Revenue
DescriptionTHE 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 Expense148876920TotalProgramServiceExpense
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10962457NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees217NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members3NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledAZStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1VIRGINIA HAVAIBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5629895100TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13800 KILROY AIRPORT WAYAddressLine1
CityLONG BEACHCity
StateCAState
ZIP Code90806ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
ELIZABETH RUSSELL
CHIEF EXECUTIVE OFFICER5.00XX048733181495
DENNIS EDER
OUTGOING DIRECTOR0.40X0132232931361
RYAN TRIMBLE
DIRECTOR0.40X092152210976
DOUGLAS JAQUES
DIRECTOR,SECRETARY5.00XX041626079903
RANDY STONE
CHIEF FINANCIAL OFFICER5.00X022689915107
DAVE FIRDAUS
CHIEF OPERATING OFFICER5.00X14447407647
RAJEEV NARULA
OUTGOING CHIEF FINANCIAL OFFICER5.00X030180941528
REBECCA LEARNER
SR. VP COMPLIANCE5.00029915040739X
MAUREEN MCGUIRRIN
OUTGOING VP OPERATIONS40.00395905024174X
GILBERT MILLER
SR. VP NATIONAL SALES40.000257055486X
THOMAS HOEHNER
VICE PRESIDENT, NETWORK MANAGEMENT40.00275777011356X
MARTIN GIBSON
CHIEF ACTUARY40.00021151726058X
JOEY ZEPEDA
VP CASE MANAGEMENT40.00185256035729X
RICHARD PEITZMEIER
VP MEMBERSHIP SALES40.00152900019643X
TINA GRAHAM
VP COMPLIANCE40.00182913013324X
THOMAS LESCAULT
FORMER PRESIDENT0.00252671011809X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1589896TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs4443872TotalReportableCompFrmRltdOrgs
Total Other Compensation451335TotalOtherCompensation
Number Individuals GT100 K10NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
EXPRESS SCRIPTS INC
21653 NETWORK PLACECHICAGOIL606731216MEDICAL SERVICES24249466
JOHN C LINCOLN NORTH MOUNTAIN HOSPITAL
250 E DUNLAP AVENUEPHOENIXAZ85020MEDICAL SERVICES6123207
BANNER BOSWELL MEDICAL CENTER
PO BOX 29693PHOENIXAZ850389693MEDICAL SERVICES4706535
SCOTTSDALE HEALTHCARE HOSPITAL
PO BOX 29682PHOENIXAZ850389682MEDICAL SERVICES4433522
BANNER BAYWOOD MEDICAL CENTER
POBOX 2978PHOENIXAZ85062MEDICAL SERVICES4359394
FieldValueIRS element (for citing)
Number Of Contractors GT100 K182NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICARE PREMIUM900099137285759137285759
PREMIUM RESERVE9000992675466226754662
FieldValueIRS element (for citing)
Total Program Service Revenue164040421TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column241837TotalRevenueColumn
Exclusion$241,837ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column164282258TotalRevenueColumn
Related Or Exempt Function Income164040421RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$241,837ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total161164Total
Management And General161164ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2169558Total
Program Services1058343ProgramServices
Management And General1111215ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total98606Total
Program Services41038ProgramServices
Management And General57568ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total241299Total
Program Services92816ProgramServices
Management And General148483ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total181351Total
Program Services80847ProgramServices
Management And General100504ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total4808208Total
Program Services776059ProgramServices
Management And General4032149ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total29186Total
Management And General29186ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total102488Total
Management And General102488ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total6852816Total
Program Services1357102ProgramServices
Management And General5495714ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total831637Total
Program Services1471ProgramServices
Management And General830166ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total97062Total
Program Services7808ProgramServices
Management And General89254ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total14966Total
Program Services5673ProgramServices
Management And General9293ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total107806Total
Management And General107806ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total113378Total
Program Services9576ProgramServices
Management And General103802ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total13987Total
Program Services1460ProgramServices
Management And General12527ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total70031Total
Program Services35793ProgramServices
Management And General34238ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
MEDICAL SERVICES FOR EL14539237114539237100
MANAGEMENT RECRUITMENT14260801426080
OFFICE EQUIPMENTS455855502400830
TELECOMMUNICATIONS333707441259290

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total43456Total
Program Services3620ProgramServices
Management And General39836ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total161550933Total
Program Services148876920ProgramServices
Management And General12674013ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY24996948BOY
EOY57821209EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY14253BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1307583BOY
EOY3990162EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY62594BOY
EOY38920EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis1951596LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1613388LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY700165BOY
EOY338208EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY5113886BOY
EOY5125006EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1592376BOY
EOY1252479EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY33787805BOY
EOY68565984EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY59042786BOY
EOY40320084EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY105152BOY
EOY509309EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY292617BOY
EOY50326934EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY59440555BOY
EOY91156327EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-25652750BOY
EOY-22590343EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-25652750BOY
EOY-22590343EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY33787805BOY
EOY68565984EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses2731325ReconcilationRevenueExpenses
Reconcilation Other Changes331082ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis883637OtherCostOrOtherBasis
Depreciation785856Depreciation
Book Value97781BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1067959OtherCostOrOtherBasis
Depreciation827532Depreciation
Book Value240427BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings338208TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
INVESTMENT IN SCAN LONG TERM CARE3500000C
OTHER RESTRICTED INVESTEMENTS1625006F
FieldValueIRS element (for citing)
Total Of Book Value Securities5125006TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
DEFERRED COMPENSATION$326,934
SURPLUS NOTE PAYABLE$50,000,000
FieldValueIRS element (for citing)
Total Of Amounts50326934TotalOfAmounts
Total Revenue164282258TotalRevenue
Total Expenses161550933TotalExpenses
Excess Or Deficit For Year2731325ExcessOrDeficitForYear
Net Unrealized GL On Investments-25918NetUnrealizedGLOnInvestments
Other$357,000OtherAmount
Total Adjustments331082TotalAdjustments
Excess Or Deficit Per FS3062407ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt137501679TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-25917NetUnrealizedGainsInvestments
Revenue Not Rptd F990-25917RevenueNotRptdF990
Revenue Subtotal137527596RevenueSubtotal
Other Revenues Not Included26754662OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt26754662RevenueNotRptdOnFinStmt
Total Revenue Per Form990164282258TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt134797160TotExpensesEtcAuditedFinclStmt
Other Expenses Included889OtherExpensesIncluded
Expenses Not Rptd F990889ExpensesNotRptdF990
Expenses Subtotal134796271ExpensesSubtotal
Other Expenses Not Included26754662OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt26754662ExpensesNotRptdOnFinStmt
Total Expenses Per Form990161550933TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
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

FieldValueIRS element (for citing)
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement1EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (16 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
ELIZABETH RUSSELL
03156490150000021682052323029172056882600
DENNIS EDER
0141030010298301078316019682011679013536900228326
RYAN TRIMBLE
056619103500000533100010976093249800
DOUGLAS JAQUES
02924040105783018073042184037719049616300
RANDY STONE
02076180001928102334012773024200600
DAVE FIRDAUS
911820460480724400076470152121000
RAJEEV NARULA
0232725053007016077017150024378034333700
REBECCA LEARNER
0222074059855017221024672016067033988900
MAUREEN MCGUIRRIN
1627220395580193625017150070240420079000
GILBERT MILLER
080739000176316000486025754100
THOMAS HOEHNER
136134015291012435207314040420287133000
MARTIN GIBSON
0153230033494024793014244011814023757500
JOEY ZEPEDA
148757026826096730129900227390220985000
RICHARD PEITZMEIER
13716901244603285010692089510172543000
TINA GRAHAM
14094403279009179012167011570196237000
THOMAS LESCAULT
0000252671011809000264480000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 3COMPENSATION 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-CPART 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 ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6THE SOLE MEMBER OF THE ORGANIZATION IS SCAN GROUP, A CALIFORNIA NONPROFIT CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7ATHE SOLE MEMBER HAS THE POWER TO APPOINT THE MEMBERS OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 11THE 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 12CSCAN 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 1515A: 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 19SCAN 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/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
SCAN GROUP
3800 KILROY AIRPORT WAYLONG BEACHCA90806953826037ADMIN. SUPPORTCA501(C)(3)LINE 11, TYPE II: 50N/A0
SCAN HEALTH PLAN
3800 KILROY AIRPORT WAYLONG BEACHCA90806953858259MEDICARE ADVANTAGECA501(C)(3)LINE 91SCAN GROUP
SCAN LONG TERM CARE
3800 KILROY AIRPORT WAYLONG BEACHCA90806204607594MEDICAID MANAGEMENT CAREAZ501(C)(4)1SCAN HEALTH PLAN ARIZONA
THE SCAN FOUNDATION
3800 KILROY AIRPORT WAYLONG BEACHCA90806450552845GRANT MAKINGCA501(C)(3)LINE 11, TYPE II: 501SCAN HEALTH PLAN
(no name)
1
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
SCAN LONG TERM CARE
P20508SEE PART VII
SCAN HEALTH PLAN
O2413913SEE PART VII
SCAN GROUP
O2394294SEE PART VII
SCAN LONG TERM CARE
N11209244SEE PART VII
SCAN LONG TERM CARE
M905463SEE PART VII
SCAN HEALTH PLAN
E50000000SEE PART VII

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
Return ReferenceSCHEDULE R, PART V:ReturnReference
ExplanationTHE 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