2011-11-10T19:19:42-06:00 2010-12-31 KPMG LLP 55 SECOND STREET SAN FRANCISCO CA 94105 990 2010-01-01 340922268 KAISER FOUNDATION HEALTH PLAN OF OHIO KAIS 5102716611 ONE KAISER PLAZA 15L OAKLAND CA 94612 KATHRYN LANCASTER 2011-10-31 4159635100 2010 2016-02-24 21:20:13Z PATRICIA KENNEDY-SCOTT ONE KAISER PLAZA 15L OAKLAND CA 94612 641212302 false X N/A X 1978 OH TO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE. 14 12 1980 0 28368 13171 80601 262333 595429126 587211818 4663007 2006156 9461492 3752200 609634226 593232507 1252547 1785835 0 0 132558050 144066609 0 0 0 488666483 502233248 622477080 648085692 -12842854 -54853185 213017630 260142184 263378405 383878920 -50360775 -123736736 X TO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE. false false 584715980 9950 590800260 member health care services and medical training for care improvement Kaiser Foundation Health Plan of Ohio (KFHP of Ohio) provides medical and surgical care, including urgent care services, extended care and home health care, for its members without regards to age, sex, race, religion or national origin or the ability to pay. KFHP of Ohio educates and trains medical students and other health care professionals and promotes scientific and nursing education in order to improve care. Additional information about Ohio Health Plan's charitable activities can be found in Schedule O, Community Benefit Report. 6478172 0 0 Charitable Care (Medical Financial Assistance and Charitable Coverage) Health Plan provides charity care to low-income vulnerable patients through the Medical Financial Assistance (MFA) and Charitable Health Coverage (CHC) Programs. MFA - Health Plan offers financial assistance to help families and individuals that are unable to pay for all or part of the cost of urgent or emergent care provided in Kaiser Permanente facility. CHC - these programs are available to low income adults and children who are not eligible for other public or privately sponsored coverage. More than 1,076 patients received comprehensive care for up to four years through these programs. Additional information about Ohio Health Plan's charitable activities can be found in Schedule O, Community Benefit Report. 1775885 1775885 0 Grants and Donations The Ohio Health Plan supported approximately 107 nonprofit organizations and enabled them to continue providing programs and services that serve vulnerable populations. Additional information about Ohio Health Plan's charitable activities can be found in Schedule O, Community Benefit Report. 955455 0 0 SCH. O, COMMUNITY BENEFIT REPORT 955455 0 0 593925492 true true false true false false false false false true false false false true false true true false false false false false false false false false true false true false false false false false false true false false false false false false true true true false false true 2054 0 true 1980 true true true false false false false false false false false false X 14 12 true false true false true true true true true false false true true true true true true true true false OH X VP - NATIONAL TAX COMPLIANCE 5102716385 ONE KAISER PLAZA 15L OAKLAND CA 94612 X Daniel Garcia 2.0 X 0 1280238 73787 George Halvorson 5.0 X X 0 7667335 76092 CHRISTINE CASSEL 0.5 X 0 172625 0 THOMAS CHAPMAN 0.5 X 0 185427 59810 WILLIAM GRABER 0.5 X 0 232123 0 J EUGENE GRIGSBY III 0.5 X 0 193743 0 JUDITH JOHANSEN 0.3 X 0 184560 0 KIM J KAISER 0.5 X 0 122875 0 PHILIP MARINEAU 0.5 X 0 193623 0 JENNY MING 0.2 X 0 182748 0 EDWARD PEI 0.5 X 0 168250 16500 J NEAL PURCELL 0.5 X 0 219738 0 CYNTHIA TELLES 0.5 X 0 182647 0 SANDRA THOMPKINS 0.5 X 0 166951 0 Daniel Beck 50.0 X 0 245012 35433 JENNIFER GARDNER 4.0 X 0 103247 54938 Patricia Kennedy-Scott 40.0 X 0 714655 166810 Kathryn Lancaster 4.0 X 0 1558076 296474 Thomas Meier 3.0 X 0 647785 107439 Donald Orndoff 5.0 X 0 508058 70932 ROCHELLE ROTH 5.0 X 0 182639 51575 Arthur Southam 5.0 X 0 2020299 353928 Deborah Stokes 2.0 X 0 622642 123860 Bernard Tyson 5.0 X 0 1942514 359961 Steven Zatkin 5.0 X 0 1247253 97716 Victoria Zatkin 4.0 X 0 311369 83647 Mark Zemelman 4.0 X 0 806199 150636 Pamela Hara 30.0 X 0 385158 63558 Greg Mercer 30.0 X 0 159286 31810 Thomas Revis 30.0 X 0 320424 82464 Belva Tibbs 30.0 X 0 313984 85546 Timothy Alberts 30.0 X 0 306873 81650 Heather Bossin 30.0 X 181871 0 75177 Carolyn Hightower 30.0 X 0 318391 82916 Michelle Richter 30.0 X 204591 0 38903 Jeffrey Wallace 30.0 X 162401 0 85434 Christine Malcolm 0.0 X 0 568721 12021 548863 24435468 2819017 81 true true false LAKE HOSPITAL SYSTEM PO BOX 714031 COLUMBUS OH 43271 HOSPITAL SERVICES 7912203 THE CLEVELAND CLINIC 9500 EUCLID AVE CLEVELAND OH 44195 HOSPITAL SERVICES 13589990 OHIO PERMANENTE MEDICAL GROUP 1001 LAKESIDE AVE CLEVELAND OH 44114 MEDICAL SERVICES 104064688 THE METROHEALTH SYSTEM 2500 METROHEALTH DRIVE CLEVELAND OH 44109 HOSPITAL SERVICES 9699443 KAISER FOUNDATION HOSPITALS 1001 LAKESIDE AVE CLEVELAND OH 44114 HOSPITAL SERVICES 76234353 178 259447 2886 262333 MBRS HLTH CARE PRM 621400 458294787 458294787 MEDICARE 621400 100914432 100914432 SUPP CHARGES/PHARM 621400 25882077 25882077 NON-PLAN & IND REV 621400 1015828 987460 28368 OTHER PROGRAM SERVICE 621400 1104694 1104694 587211818 1943821 1943821 0 0 135390 135390 135390 135390 48036230 5900 47979795 0 56435 5900 62335 62335 0 0 0 PP&L INSURANCE PREMIUM REIMBURSEMENT 900099 3616810 3616810 3616810 593232507 590800260 28368 2141546 1785835 1785835 0 0 0 0 0 90188688 78662051 11526637 0 12949339 12949339 33989362 27223202 6766160 6939220 6901907 37313 0 64020 64020 787031 787031 24885 24885 0 65691 65691 125217251 122279139 2938112 10886004 81207 10804797 1368045 1062000 306045 41804724 33615306 8189418 0 5317006 5315156 1850 901784 572225 329559 0 198936 198936 2405622 2405622 0 6345330 6345330 391571 391571 CONTRACTUAL PAYMENTS 180299042 180299042 SUPPLIES 73374516 65109907 8264609 INTER-REGIONAL CHARGES 18317112 17553000 764112 PREMIUM RESERVES 17700000 17700000 STATE & LOCAL TAXES 6138541 6138541 10626137 7469421 3156716 648085692 593925492 54160200 0 23401831 21275690 106229122 153901087 14158435 14804269 5797003 5705521 556236 859883 174262094 111268360 62368503 62993734 506500 602000 213017630 260142184 60159455 66199034 12256737 9420367 190962213 308259519 263378405 383878920 X 4896101 4895579 -55256876 -128632315 -50360775 -123736736 213017630 260142184 X -54853185 -18522776 X false true true X true true X 289999 190337 164696 80601 262333 987966 574281701 593239328 592918588 595429126 587211818 2943080561 574571700 593429665 593083284 595509727 587474151 2944068527 2944068527 7142100 6257742 5406147 4393255 2079211 25278455 7142100 6257742 5406147 4393255 2079211 25278455 581713800 599687407 598489431 599902982 589553362 2969346982 0.99149 0.98924 0.00851 0.01076 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 14931 true 4977 true 4977 24885 false Schedule C, Part II-B, Line 1A - 1I LOBBYING ACTIVITY BY NONELECTING PUBLIC CHARITIES The Organization is a member of the Kaiser Permanente Medical Care Program and participated and benefited from lobbying activities conducted at the regional and national level for the benefit of its enrolled members and for the health care industry as a whole. As an organization generally exempt from income tax under Internal Revenue Code Section 501(c)(3), Health Plan has a policy prohibiting internal involvement in any political campaigns. This policy is closely monitored for compliance. During the year this Organization may have made comments or statements concerning legislation which may affect the health care industry. Health Plan may have engaged in telephone conversations and/or written letters to various federal, state, and local officials regarding matters which affected the healthcare industry as a whole. The amount of time and money involved in the activities is detailed on lines a through i. Health Plan has several employees and/or may retain a professional consultant to represent Health Plan's interests in various legislative and regulatory bodies and from time-to-time to keep informed of Federal and State legislation having an impact on Health Plan's charitable activities as an exempt Health Maintenance Organization. These individuals attempt to ensure that proposed legislation and enacted laws are compatible with the Interest of Health Plan and its members by performing the following activities: (i) Collecting, analyzing and distributing within the Organization, public and private policy recommendations regarding proposed legislation that affect the operation of Health Plan and its ability to provide quality health and medical care services to its members in a cost effective environment. (ii) Providing appropriate informational materials to legislators and to their staffs that pertain to matters of common interest in the health care community and in the not-for-profit community. (iii) Also by preparing written and oral testimony, these individuals appear at legislative hearings, monitor legislative proceedings and meet with legislators and/or their staffs regarding issues pertinent to the mission of Health Plan. Those individuals appearing at such hearings and meetings for and on behalf of Health Plan often are representing the interests of common interest groups as well as the interests of the members of Health Plan. (iv) Other employees and officers perform services by delivering speeches at various public and private functions and in serving as faculty in healthcare related educational programs throughout the community. 5961963 5961963 89515096 42000673 47514423 6435008 4338873 2096135 44631211 38223763 6407448 27718816 26705051 1013765 62993734 0 DUE TO AFFILIATED ORGANIZATION 30384964 RESERVE FOR PROF & PUBLIC LIAB 14764873 RESERVE FOR WORKERS COMP RISK 3499674 POST RETIREMENT BENEFITS 167617396 OTHER LIABILITIES 2603429 SELF INSURED - AUTO & UNEMPLOY 42567 SUBORDINATED LIABILITIES 62317192 MEDICARE LIABILITY RESERVE 9329424 PREMIUM DEFICIENCY RESERVE 17700000 308259519 593232507 648085692 -54853185 1439164 -19961943 -18522779 -73375964 588018865 1439164 -2979561 -1540397 589559262 3673245 3673245 593232507 661394307 16925425 16925425 644468882 3616810 3616810 648085692 Schedule D, Part XI, Line 8 DECREASE IN OTHER COMPREHENSIVE INCOME $ (19,718,003) DECREASE IN CAPITAL CONTRIBUTION ( 522) Gain/Loss on Investments - Tax ( 56,435) Gain/Loss on Investments - Book 147,998 See "note 1" ( 334,981) _______________ TOTAL $ (19,961,943) Note 1: other than temporary impairment (OTTI) of investment recognized for financial statement purposes, which will be tax reported when realized Schedule D, Part XII, Line 2d Bad debt expense - Reclass $ (2,726,887) Gain(Loss) on Investments - Book 147,998 OTTI (334,981) Investment Management Fees (65,691) _____________ TOTAL $ (2,979,561) Schedule D, Part XII, Line 4b OTHER REVENUE - RECLASS 3,616,810 GAIN(LOSS) ON INVESTMENTS - TAX 56,435 ___________ TOTAL $ 3,673,245 Schedule D, Part XIII, Line 2d Decrease in Other Comprehensive Income $ 19,718,003 Bad debt expense - Reclass (2,726,887) Investment Management Fees (65,691) _____________ TOTAL $ 16,925,425 Schedule D, Part XIII, Line 4b Insurance Expense - Reclass $ 3,616,810 Schedule D, Part X, Line 2 FIN 48 FOOTNOTE NOT REQUIRED true Asian Services in Action Inc 3631 Perkins Ave 2A W Cleveland OH 44114 341798850 501(c)(3) 24993 Health Activities and Promotion Initiative (HAPI) Battered Women's Shelter 759 W Market St Akron OH 44303 341249342 501(c)(3) 16720 The Tina Project Beech Brook 3737 Lander Rd Pepper Pike OH 44124 340714597 501(c)(3) 20000 Family Drop-In Center Care Alliance 1530 St Clair Ave Cleveland OH 44114 341748776 501(c)(3) 23688 Sponsorship Let's Talk Turkey; Raising Up Clevelan Case Western Reserve University 1380 E Sixth St Cleveland OH 44114 341018992 501(c)(3) 10000 National Youth Sports Program Cleveland Board of Education 1380 E Sixth St Cleveland OH 44114 346000662 Government 597500 Sponsorship Family & Community Empowerment Conf.; Cleveland Clinic Foundation 600 W Creek Rd 10 MC RC-25 Independence OH 44131 340714585 501(c)(3) 63000 Community Benefit and Charity Care Services Cleveland Foodbank Inc 15500 South Waterloo Rd Cleveland OH 44110 341292848 501(c)(3) 59100 Market Under Glass; Donation (2x); KP Gives Gift M Cleveland Hearing and Speech Center 11635 Euclid Ave Cleveland OH 44106 340714648 501(c)(3) 15000 Regional Infant Hearing Program Cleveland International Film Festival Inc 2510 Market Ave Cleveland OH 44113 341262368 501(c)(3) 5250 34th Annual International Film Festival; KP Gives Cleveland Museum of Natural History 1 Wade Oval Dr Univ Circle Cleveland OH 44106 340714338 501(c)(3) 9000 2010 Kelley Cup Sponsorship; Health Literacy Partn Cleveland Rape Crisis Center 526 Superior Ave 1400 Cleveland OH 44114 510164315 501(c)(3) 19725 2010 Sing Out Donation (2x); Comprehensive Approac Cleveland State University Foundation Inc 2121 Euclid Ave MM105 Cleveland OH 44115 341316665 501(c)(3) 41199 Careers in Health and Medical ProfessionS Cuyahoga Community College Fdn 700 Carnegie Ave Cleveland OH 44115 237320719 501(c)(3) 5500 Sponsorship - Bridging Pathways to Health Careers Cuyahoga Valley National Park Assoc 1403 W Hines Hill Road Peninsula OH 44264 341917257 501(c)(3) 15000 Urban Youth Outreach Diabetes Association of Greater Cleveland 3601 So Green Rd 100 Cleveland OH 44122 340762558 501(c)(3) 22620 Swim for Diabetes 2010; Diabetes Education at Safe Domestic Violence Center PO Box 5466 Cleveland OH 44101 341278377 501(c)(3) 5250 Break the Silence, Break the Cycle Sponsorship; KP Fairhill Partners 12200 Fairhill Road Cleveland OH 44120 341549927 501(c)(3) 21843 Multi-Generational Health Promotion Free Medical Clinic of Greater Cleveland 12201 Euclid Ave Cleveland OH 44106 237078501 501(c)(3) 25000 Teen Clinic and Teen Outreach Progams Gathering Place 23300 Commerce Park Cleveland OH 44122 341879035 501(c)(3) 20000 Children and Family Programs for those Touched by Harvard Community Services Center 18240 Harvard Cleveland OH 44128 237098744 501(c)(3) 77280 HEAL - Ward 1 Community Health Initiative (4x) Helen Keller International 352 Park Ave S 1200 New York NY 10010 135562162 501(c)(3) 10000 ChildSight Ohio Hospice of the Western Reserve Inc 300 E 185th St Cleveland OH 44119 341256377 501(c)(3) 14466 Together We Can Bereavement Camp Ideastream 1375 Euclid Ave Cleveland OH 44115 341943865 501(c)(3) 10000 Health Initiative Legal Aid Society of Cleveland 1223 W Sixth St Cleveland OH 44113 340866026 501(c)(3) 25000 Community Advocacy Program Lesbian Gay Bisexual Transgender Comm Ctr 6600 Detroit Ave Cleveland OH 44102 341190920 501(c)(3) 10000 Sex Smart Mature Services Inc 415 S Portage Path Akron OH 44320 510148544 501(c)(3) 10000 Brown Bag Medication Program Mental Health America of Summit County Inc 20 Olive St 404 Akron OH 44310 340840366 501(c)(3) 10000 Adolescent Suicide Prevention Program MetroHealth Foundation Inc 2500 MetroHealth Dr Suite 135A Cleveland OH 44109 346607695 501(c)(3) 50504 Diagnosing and Treating Hypertension in Children a Minority OrganTissue Transplant Education 11717 Euclid Ave Cleveland OH 44106 341900839 501(c)(3) 10000 Hospital Organ Donation/Education Registration Pro MobileMed1 Foundation 19910 Melvern Rd Shaker Heights OH 44122 264038371 501(c)(3) 25000 Donation Neighborhood Family Practice 3569 Ridge Road Cleveland OH 44102 341300581 501(c)(3) 20000 Hispanic Patient Advocate North Coast Health Ministry 16110 Detroit Ave Cleveland OH 44107 341536257 501(c)(3) 19876 Women's Preventive Health Program Ohio State University Foundation 9127 Miles Ave Cleveland OH 44105 311145986 501(c)(3) 45547 HEAL Grant (2x) Providence House Inc 2037 W 32nd St Cleveland OH 44113 341336325 501(c)(3) 5980 Sponsorship Shades of Blue Luncheon; KP Gives Gift Saint Martin De Porres High School 6111 Lausche Ave Cleveland OH 44103 522401852 501(c)(3) 7350 Work Study Program Senior Outreach Services 2390 E 79th St Cleveland OH 44104 341346752 501(c)(3) 20000 Health & Wellness Program Slavic Village Development 5620 Broadway Ave Cleveland OH 44127 341344279 501(c)(3) 20000 Pedaling for Health in the Village Stella Maris Inc 1320 Washington Ave Cleveland OH 44113 340896181 501(c)(3) 10000 Electronic Medical Record System Summa Akron City & St Thomas Hospitals 168 E Market St Akron OH 44309 340714755 501(c)(3) 100000 Community Benefit & Charity Care Services (2x) Summa Hospitals Foundation 525 E Market St Akron OH 44304 341219001 501(c)(3) 50000 Assessment and Treatment of Children and Adolescen United Cerebral Palsy Assoc Grtr Cleveland 10011 Euclid Ave Cleveland OH 44106 340753561 501(c)(3) 10000 Steps to Independence Intensive Therapy United Way of Greater Cleveland 1331 Euclid Ave Cleveland OH 44115 346516654 501(c)(3) 8000 Donation University Hospitals Health System Inc 11100 Euclid Ave Cleveland OH 44106 340714775 501(c)(3) 30637 637 Centering Pregnancy Program West Side Ecumenical Ministry 5209 Detroit Ave Cleveland OH 44102 237034175 501(c)(3) 12500 Donation; Youth Health Module Young Mens Christian Assoc of Cleveland OH 2200 Prospect Ave 900 Cleveland OH 44115 340714728 501(c)(3) 10000 We Run This City Youth Marathon Program Youth Opportunities Unlimited 1361 Euclid Ave Cleveland OH 44115 341381135 501(c)(3) 6030 Sponsorship Youth Career Olympics (2x); Founder's YWCA of Greater Cleveland 4019 Prospect Ave Cleveland OH 44103 340714800 501(c)(3) 8530 Sponsorship - Women of Achievement Awards & Women' Cuyahoga Community College Foundation 700 Carnegie Ave Cleveland OH 44115 237320719 501(c)(3) 11700 Donation United Way of Greater Cleveland 1331 Euclid Avenue Cleveland OH 44115 346516654 501(c)(3) 5846 Sponsorship - Golf ProAM 50 0 Schedule I, Part I, Question 2 Grantees are required to sign a memorandum of understanding prior to grant funds disbursal. Grantees are required to submit a final report which delineates accomplishments, related to stated objectives, and describe the evaluation method used to assess accomplishments true true false false false false false true false Timothy Alberts 0 196157 0 77965 0 32751 0 65990 0 15660 0 388523 0 0 Daniel Beck 0 187296 0 55101 0 2615 0 19773 0 15660 0 280445 0 0 Heather Bossin 168318 0 9183 0 4370 0 59078 0 16099 0 257048 0 0 0 Daniel Garcia 0 517930 0 585000 0 177308 0 62481 0 11306 0 1354025 0 151518 JENNIFER GARDNER 0 95718 0 6040 0 1489 0 41870 0 13068 0 158185 0 0 George Halvorson 0 1177487 0 5155125 0 1334723 0 62481 0 13611 0 7743427 0 0 Pamela Hara 0 183190 0 0 0 201968 0 50058 0 13500 0 448716 0 0 Carolyn Hightower 0 202275 0 83396 0 32720 0 67256 0 15660 0 401307 0 0 Patricia Kennedy-Scott 0 362953 0 312689 0 39013 0 150579 0 16231 0 881465 0 0 Kathryn Lancaster 0 615090 0 919900 0 23086 0 283406 0 13068 0 1854550 0 0 Christine Malcolm 0 0 0 0 0 568721 0 0 0 12021 0 580742 0 0 Thomas Meier 0 316076 0 297094 0 34615 0 94371 0 13068 0 755224 0 0 Greg Mercer 0 32812 0 119873 0 6601 0 28800 0 3010 0 191096 0 0 Donald Orndoff 0 333479 0 0 0 174579 0 57212 0 13720 0 578990 0 0 Thomas Revis 0 206574 0 96107 0 17743 0 66804 0 15660 0 402888 0 0 Michelle Richter 143608 0 56525 0 4458 0 23375 0 15528 0 243494 0 0 0 ROCHELLE ROTH 0 156416 0 23838 0 2385 0 38895 0 12680 0 234214 0 0 Arthur Southam 0 735252 0 1241861 0 43186 0 342622 0 11306 0 2374227 0 0 Deborah Stokes 0 313713 0 249552 0 59377 0 110792 0 13068 0 746502 0 40338 Belva Tibbs 0 207427 0 90298 0 16259 0 69315 0 16231 0 399530 0 0 Bernard Tyson 0 737887 0 1180500 0 24127 0 346893 0 13068 0 2302475 0 0 Jeffrey Wallace 148179 0 7333 0 6889 0 69906 0 15528 0 247835 0 0 0 Steven Zatkin 0 283028 0 932500 0 31725 0 86239 0 11477 0 1344969 0 0 Victoria Zatkin 0 196570 0 80174 0 34625 0 81763 0 1884 0 395016 0 0 Mark Zemelman 0 342852 0 224105 0 239242 0 137956 0 12680 0 956835 0 57187 CHRISTINE CASSEL 0 172625 0 0 0 0 0 0 0 0 0 172625 0 0 THOMAS CHAPMAN 0 185427 0 0 0 0 0 59810 0 0 0 245237 0 0 WILLIAM GRABER 0 232123 0 0 0 0 0 0 0 0 0 232123 0 0 J EUGENE GRIGSBY III 0 193743 0 0 0 0 0 0 0 0 0 193743 0 0 JUDITH JOHANSEN 0 184560 0 0 0 0 0 0 0 0 0 184560 0 0 PHILIP MARINEAU 0 193623 0 0 0 0 0 0 0 0 0 193623 0 0 JENNY MING 0 182748 0 0 0 0 0 0 0 0 0 182748 0 0 EDWARD PEI 0 168250 0 0 0 0 0 16500 0 0 0 184750 0 0 J NEAL PURCELL 0 219738 0 0 0 0 0 0 0 0 0 219738 0 0 CYNTHIA TELLES 0 182647 0 0 0 0 0 0 0 0 0 182647 0 0 SANDRA THOMPKINS 0 166951 0 0 0 0 0 0 0 0 0 166951 0 0 Schedule J, Line 3 Kaiser foundation health plan of ohio relied on kaiser foundation health plan, inc. that used one or more of the methods described below to establish the top management officials' compensation: - Compensation committee - Independent compensation consultant - Form 990 of other organizations - Written employment contract - Compensation survey or study - Approval by the board or compensation committee Schedule J, Line 4a CHRISTINE MALCOLM $568,515 Listed persons participated in arrangements entitling them to severance benefits in the event of termination by the organization without cause or due to job elimination. Depending on position level, tenure, and termination reason, severance benefits payable under these arrangements provide for pay and health benefits continuation plus payment of accrued obligations. In addition, for some of the listed persons, severance benefits payable include prorated incentive awards for performance periods not yet ended. None of the listed persons participated in arrangements entitling them to change-of-control payments. Schedule J, Line 4b GEORGE C. HALVORSON 1,237,500 KATHRYN LANCASTER 368 THOMAS MEIER 609 DEBORAH STOKES 40,338 STEVEN ZATKIN 5,463 MARK ZEMELMAN 218,741 DANIEL GARCIA 151,518 Some of the listed persons participated in nonqualified supplemental retirement plans. Under these plans, the organization makes annual contributions to accounts held in the name of individual participants. Contributions vary by position level and pay, and vest over time based on age and/or service. Participant accounts are credited with actual investment returns from up to four mutual funds and/or with a fixed rate of interest or a combination thereof. Unvested amounts are subject to risk of forfeiture. Schedule J, Line 7 The organization provided non-fixed payments to some of the persons listed. Payments were made under incentive plans, based on attainment of organizational performance goals and individual performance, designed to support the organization's mission to provide high-quality, affordable care and improve the health of its members and the communities it serves. MARK MALCOLM KFHP INC EMPLOYEE 96476 COMPENSATION false Form 990, Part VI, Line 2 Family Affiliations Steven r zatkin - spouse: officer of Kaiser Foundation Health Plan, Inc (KFHP Inc), Kaiser Foundation Hospitals (KFH) and subsidiaries Victoria zatkin - spouse: senior vp, general counsel and officer of kfh, kfhp inc. and regional health plans Form 990, Part VI, Line 4 Changes to governing documents On June 24, 2010, Article E., Officers, of the Bylaws of the Corporation was amended to provide for the title of Ambulatory Surgery Center ("ASC") Administrator, and to add a new Section E-11 to provide for the appointment of an ASC Administrator at each ASC operated by the Corporation and to set forth the authority and responsibilities of an ASC Administrator. On March 3, 2011, Article E., Officers, of the Bylaws of the Corporation was amended to (a) provide that the officers of the Corporation may include one or more Group Presidents (Section E-1, Officers); (b) add a new Section E-8, Group President and/or Regional President, to describe the duties and responsibilities of those positions; (c) provide that the President shall be the Chief Operating Officer of the Corporation (Section E-7, President); (d) provide clarification regarding leadership in the event of the absence or disability of the President (Section E-9, Executive Vice President or National Senior Vice President); and (e) change the reference to "the President" in Sections E-3, E-4 and E-11 to "any President". Form 990, Part VI, Line 6 KAISER FOUNDATION HEALTH PLAN, INC IS SOLE MEMBER Upon dissolution, remaining assets shall be distributed to a 501(c)(3) organization Form 990, Part VI, Line 7a Kaiser Foundation Health Plan, Inc (KFHP) appoints the Directors (and fills vacancies and has authority to remove Directors). The same 14 individuals who comprise the Board of Directors of KFHP also serve as the 14 Directors of KFHP Colorado, Ohio, Northwest and Mid-Atlantic States Form 990, Part VI, Line 7b The following actions of the corporation require approval of the sole member: a. removal of the Chairman of the Board or the Regional President; b. amendment of Article D, Section D-4 of the Bylaws - Election and Term of Office of Directors Form 990, Part VI, Line 11b Form 990 review process 1. Key information necessary for the preparation of the tax return is obtained and/or confirmed with internal sources including regional finance, executive compensation, community benefits, treasury, government relations, and legal 2. Community benefits details are presented to the community benefit committee of the board for review 3. Executive compensation details are presented to the compensation committee of the board for review 4. The complete tax return is reviewed and signed by a KPMG tax advisor 5. The complete tax return is reviewed and signed by an officer or a member of management designated by an officer 6. The tax return is discussed with the full board of directors. A copy of the return is provided to each board member in electronic format prior to filing Form 990, Part VI, Line 12c Regularly and Consistently Monitors Compliance with the Conflicts of Interest Policy Kaiser Permanente regularly monitors compliance with the Conflicts of Interest Policy in 3 key ways: 1. The Kaiser Permanente Compliance Hotline is available to all employees and vendors to report actual or potential conflicts of interest. All calls are answered by a third party and provided to Kaiser Permanente's National Compliance Office for review and appropriate action. Employees can report anonymously. Retaliation is prohibited. Reports of actual or potential Conflicts of Interest are generated and investigations are conducted as required and information is tracked and trended to determine if additional guidance is required to avoid or manage conflicts of interest. Compliance Hotline Reports are provided for review and action to the Kaiser Foundation Health Plan/ Hospitals Boards of Directors annually. 2. 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/b The executive compensation program is designed to recruit, retain and motivate qualified senior management personnel. Senior management personnel have a significant impact on the strategic and policy direction and results of the organization. Therefore, the executive compensation program is, to a significant degree, performance-based. The compensation program is reviewed annually by the Compensation Committee of the Board of Directors which evaluates and approves, prior to payment, all programs and payments to CEO, Executive Director and top management officials (executives). Base pay for executive positions is established at a level comparable to the relevant market. In addition, other components of the compensation program bear 'at-risk' features designed to focus on strategically important performance goals and to assist in attracting and retaining top performers. The executive compensation program is targeted at the median of the comparable external market in which the organization competes for executive leadership. Evaluation of comparable pay data is performed by an Independent Compensation, Benefit & Human Resource Consulting firm. The compensation program focuses on objectives in the areas of quality of member care and service, financial soundness, and the community and social mission of the organization. Form 990, Part VI, Line 19 Public Inspection Governing documents - are available as provided to state Dept. of Insurance and maintained on state agency website or upon request. Conflict of Interest is available on KP website under vendor Principles of Responsibility or upon request. Financial Statements are on file with state insurance agency on a statutory basis (stand alone entity). Combined data is published for Kaiser Foundation Health Plan Inc. and subsidiaries and Kaiser Foundation Hospitals and Subsidiaries with audit opinion by KPMG and is available upon request. To request copies contact: VP - National Tax Compliance Kaiser Foundation Health Plan and Hospitals One Kaiser Plaza, Ste 15L Oakland, CA 94612 Form 990, Part VII, Section A, Column B Hours for Related Organizations Individuals who are both officers and members of Boards of Directors work full time as employees as well as fulfill their board assignment. All officers work full time in their employee capacity. Full time work may require in excess of the traditional 40 hour week. Given the integrated nature of our organization, employees may provide support for various Kaiser Permanente companies. The average hours per week reported for the filing organization and related organizations was estimated. Form 990, Part XI, Line 5 Other changes in net assets or fund balances Change in unrealized gain/loss on investments $ 1,439,164 Change in Other Comprehensive Income < 19,718,000> Change in Capital Stock < 522> Gain/Loss on investments - Tax < 56,435> Gain/Loss on Investments - Book 147,998 OTTI Losses < 334,981> ______________ TOTAL <$18,522,776> Form 990, Part III, Line 4a - d Exempt purpose achievements - Program Services 2010 COMMUNITY BENEFIT REPORT KAISER FOUNDATION HEALTH PLAN OF OHIO Kaiser Foundation Health Plan of Ohio or "Ohio Health Plan" is a tax-exempt subsidiary health plan of Kaiser Foundation Health Plan, Inc. (KFHP). Kaiser Foundation Health Plan of Ohio as well as Kaiser Foundation Hospitals (KFH) are nonprofit corporations that are part of the integrated health care delivery system known as the Kaiser Permanente Medical Care Program or "Kaiser Permanente." In 2010, the Ohio Health Plan served 122,342 members and had 1,586 full time administrative, clerical and technical employees. Ohio Health Plan provides and arranges comprehensive health care services for members on a predominantly prepaid basis. Health Plan fulfills its contractual obligations to group and individual members by contracting with KFH and Ohio Permanente Physicians to provide the required health care services. Membership in KFHP and its health plan subsidiaries is available without regard to sex, race, religion, ethnic background, sexual orientation, and occupational status or income level. Health Plan members are broadly representative of the various ages, social, and income groups within the areas it serves. Once enrolled, a member is free to maintain membership regardless of age, health status or employment. KAISER PERMANENTE'S COMMITMENT TO THE COMMUNITY Kaiser Permanente believes its Direct Community Benefit Investment (DCBI), is fundamental to being a nonprofit organization. It embodies the organization's commitment to improve the health of communities beyond services to Health Plan members. It is more than traditional corporate citizenship or corporate philanthropy. It is an intentional, planned, budgeted, measurable, accountable creation for better health in our communities. It is done in collaboration with, not in isolation from, the community. DCBI serves to fulfill Kaiser Permanente's social purpose, justify its tax-exempt status, and differentiate it from other health care organizations. This tradition of community benefit dates from the earliest days of the Program, when charitable care to non-employees, and later, nonmembers, was initiated. That heritage has continued through the years in Kaiser Permanente's early participation in publicly financed programs such as Medicaid and Medicare, establishment of residency training and medical research programs, and later, in the development of the Educational Theatre, Safety Net Partnerships, Community Health Initiatives and Charitable Coverage Programs. In 2007, the KFHP/H Board of Directors refined the focus of the organization Community Benefit Program and established the following four priority areas which have come to be known as "streams of work": - Care and Coverage for Low-Income People - Creates and supports programs that lower the financial barriers for under- and uninsured. - Community Health Initiatives - Designs, delivers, and sustains long-term programs that engage communities in work to improve conditions in their neighborhoods. - Safety Net Partnerships - Builds partnerships with community clinics, local health departments, and public hospitals. Provide funding, technical assistance, dissemination of care management and quality improvements technology to help improve care and expand treatment capacity for vulnerable populations. - Developing and Disseminating Knowledge - Improve health care by sharing our knowledge- educating practitioners, advancing research, empowering consumers and informing policymakers about the evidence base for care and health. The Board elaborated that at least 75% of total community benefit funding will be directed to program priorities within the four streams of work and the remaining 25% of funding will be directed by local regions to respond to local community benefit needs and opportunities that may or may not be within the four key focus areas. THE COMMUNITY BENEFIT PROGRAM IN THE OHIO REGION In 2010, the Ohio Health Plan spent approximately $10.8 million or approximately 1.8% of revenue to support the Community Benefit Program. A breakdown of the 2010 Community Benefit dollars is included in Attachment A. The following identifies many of the signature community benefit programs and services funded by Ohio Health Plan grouped according to the four streams of work. . CARE AND COVERAGE FOR LOW-INCOME PEOPLE In 2010, the Ohio Health Plan expended $8.1 million to address the financing and delivery of health care for populations vulnerable due to socio-economic status, illness, ethnicity, age or other factors. Program beneficiaries (under- and uninsured) received free or discounted care in a Kaiser Permanente facility or by a Permanente provider. Charitable Care (Medical Financial Assistance and Charitable Coverage Programs) In the Ohio Region, Health Plan provides charity care to low-income vulnerable populations through the Medical Financial Assistance and Charitable Coverage Programs. In 2010, the Ohio Health Plan spent $6.5 million on under-and uninsured Ohio residents. - Medical Financial Assistance The Ohio Health Plan contributed $1.3 million to assist patients with limited or no resources to pay for care provided in Kaiser Permanente facilities. Each region offers financial assistance to help families and individuals that are unable to meet all or part of the cost of medical care on an immediate and nonrecurring basis. Kaiser Permanente's charity care program also includes discounted charges for uninsured patients below 400% federal income guidelines and aligned contracted collection agency practices with Kaiser Permanente social values. The amount reported under this category is only part of the funds spent by KFH and KFHP for the poor and uninsured. The organization's commitment to charitable care is also reflected in a variety of other programs and initiatives such as the Charitable Coverage Program and grants and donations to community clinics and other safety net providers. Medical Financial Assistance is offered to both members and non members, and eligibility is solely based on income. - Charitable Coverage Transition Plan - This program provides coverage for low income individuals and who are not eligible for government sponsored health care programs such as Medicaid or Medicare. Based on income (at or below 250% of federal poverty level), the plan subsidizes nearly all health care coverage costs. Referrals to this program are made by community partners. Transition Plan members minimally share in the cost of coverage and pay a premium of $20 per month for individuals and $40 per month for families. They receive comprehensive benefits, including prescription drug coverage and hospitalization. Participation in Medicaid and Other Government Sponsored Health Care Programs The Ohio Health Plan has a long history of participation in publicly financed health programs. In 2010, the Ohio Region provided medical coverage and services valued at approximately $1.6 million (in excess of reimbursement) for individuals in the following program: - Medicare-Medicaid Premium Subsidy - In Ohio, state policy does not allow use of state dollars to pay for Medicare monthly premiums, even for low-income persons. Health Plan paid the monthly Medicare premium for dual-eligible Medicare/Medicaid members. This effort supports low-income persons and provides richer Medicare benefits than fee-for-service. COMMUNITY HEALTH INITIATIVES As an innovator in health, Kaiser Permanente designs, delivers and sustains long-term programs that engage communities in work to improve the conditions in their neighborhoods, workplaces and schools that can support good health, particularly Healthy Eating, Active Living (HEAL). The Ohio Health Plan spent $398,487 on community health initiatives during 2010. Community Health Education and Prevention Programs The Ohio Health Plan provides a variety of health education classes, events and programs for the general public. Expenditures in this category exclude program cost for health education programs targeting or restricted to Health Plan members. The following are examples of community partnerships aimed at promoting health and well being. In 2010, the Ohio Health Plan sponsored numerous community health screenings and participated in health events throughout the region. Many events allowed us to strengthen relationship with the community. SAFETY NET PARTNERSHIPS Through funding, technical assistance, influencing public policy, training and volunteering, dissemination of care-management and quality improvement technologies, Kaiser Permanente helps these vital health care providers improve care and expand treatment capacity for the communities and vulnerable people they serve. The Ohio Health Plan donated $368,499 to support safety net providers through its Thriving Communities Grant Program. . DEVELOPING AND DISSEMINATING KNOWLEDGE Kaiser Permanente aims to improve health by sharing its knowledge, educating practitioners, advancing research, empowering consumers, and informing policymakers about the evidence base for care and health. The Ohio Health Plan spent $640,827 to support programs and services for the development and dissemination of knowledge and provided grants and donations to nonprofit organizations. Educational Theatre Programs (ETP) The Ohio Health Plan's Educational Theatre Programs is based upon a new model for promoting health through theatre. Under this model, the Ohio Region collaborates with Cleveland Municipal School District to create a program that uses theatre to train school-based youth actors as health education ambassadors as well as deliver health messages to large audiences. The program is comprised of three productions - Secrets, which educates students about the dangers of HIV/AIDS and other sexually transmitted diseases; the Amazing Food Detective, designed to educate elementary school students about the importance of good nutrition and exercise and Peace Signs which delivers an anger management, anti-bullying message for the middle-school age group. ETP presented 29 performances to 7,943 children and adults. Grants and Donations for Knowledge Dissemination The Ohio Health Plan contributed $270,423 to support thirty six community-based organizations. Care Alliance Health Center Care Alliance's Raising Up Cleveland project will provide preventive services and educational opportunities to Care Alliance patients with the long term goal of reducing health disparities and incidence of chronic disease. The program has two main components: interactive learning to increase knowledge of Healthy Eating/Active Living activities and resource facilitation to reduce barriers to wellness. Cleveland Foodbank A Thriving Communities grant will support the expansion of the Cleveland Foodbank's Children's Nutrition Initiative (CNI). CNI is designed to meet the needs of children at risk of hunger. Through the BackPacks for Kids, Kids Cafes and Summer Feeding Programs, Cleveland Foodbank ensures that participating children do not go hungry in the evenings, on weekends, or over summer vacation. Regional Community Benefit Operations The Ohio Health Plan has a dedicated Community Benefit Department with three full time employees to coordinate CB initiatives and support regional community benefit programs and services. ATTACHMENT A 2010 COMMUNITY BENEFIT INVESTMENT - OHIO REGION The following chart summarizes the 2010 Community Benefit investments by the Ohio Health Plan. The investments in the community reflected in the chart are unaudited. REGIONAL HEALTH PLAN TOTAL CARE AND COVERAGE Charitable Care & Coverage Programs $6,478,172 Government Sponsored Programs 1,636,830 Grants & Donations for Care & Coverage 20,000 Subtotal: $8,135,002 COMMUNITY HEALTH INITIATIVES Community Health Education $15,857 Grants & Donations for Community Health Initiatives 349,253 Community Health Initiatives CB Operations 33,378 Subtotal: $398,488 SAFETY NET PARTNERSHIPS Grants & Donations for Safety Net Partnerships $368,499 Subtotal: $368,499 KNOWLEDGE DISSEMINATION Medical Research $183,399 Educational Theatre Program 157,426 Health Care Training & Education Programs 29,579 Grants & Donations for Knowledge Dissemination 270,423 Subtotal: $640,827 OTHER COMMUNITY Self Sufficiency Programs $67,353 Other CB Grants & Donations 767,710 Other CB Operations 468,463 Subtotal: $1,303,526 TOTAL $10,846,342 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Daniel Garcia TITLE:SVP, Chief Compliance Officer HOURS:48 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:George Halvorson TITLE:Chairman and CEO HOURS:45 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:CHRISTINE CASSEL TITLE:DIRECTOR HOURS:7 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:THOMAS CHAPMAN TITLE:DIRECTOR HOURS:9 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:WILLIAM GRABER TITLE:DIRECTOR HOURS:8 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:J. EUGENE GRIGSBY III TITLE:DIRECTOR HOURS:8 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JUDITH JOHANSEN TITLE:DIRECTOR HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KIM J. KAISER TITLE:DIRECTOR HOURS:8 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:PHILIP MARINEAU TITLE:DIRECTOR HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JENNY MING TITLE:DIRECTOR HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:EDWARD PEI TITLE:DIRECTOR HOURS:8 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:J. NEAL PURCELL TITLE:DIRECTOR HOURS:9 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:CYNTHIA TELLES TITLE:DIRECTOR HOURS:7 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SANDRA THOMPKINS TITLE:DIRECTOR HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Daniel Beck TITLE:VP, Regional Counsel - Ohio HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JENNIFER GARDNER TITLE:Special Asst to BOD HOURS:46 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Patricia Kennedy-Scott TITLE:Region President - Ohio HOURS:10 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Kathryn Lancaster TITLE:EVP & CFO HOURS:46 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Thomas Meier TITLE:SVP, Corporate Treasurer HOURS:47 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Donald Orndoff TITLE:SVP, NFS HOURS:45 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ROCHELLE ROTH TITLE:SENIOR DIRECTOR,QRM HOURS:45 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Arthur Southam TITLE:EVP, Health Plan Operations HOURS:45 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Deborah Stokes TITLE:SVP, CC & CAO HOURS:48 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Bernard Tyson TITLE:President & COO HOURS:45 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Steven Zatkin TITLE:SVP, Gen Counsel & Secretary HOURS:45 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Victoria Zatkin TITLE:VP, Off of Brd & Corp Gov Svcs HOURS:46 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mark Zemelman TITLE:SVP, Gen Counsel & Secretary HOURS:46 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Pamela Hara TITLE:VP, Quality/Service HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Greg Mercer TITLE:VP, Health Plan Mgr. - 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