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CAMP BOWIE SERVICE CENTER: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
CAMP BOWIE SERVICE CENTER (EIN 94-3299123)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-11
IRS object ID
201113159349301941
Schema version
2010v3.4
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)
Timestamp2011-11-11T10:49:37-06:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line155 SECOND STREETAddressLine1
CitySAN FRANCISCOCity
StateCAState
ZIP Code94105ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN943299123EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CAMP BOWIE SERVICE CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCAMPNameControl
Phone5102716611Phone

US Address USAddress

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

Officer Officer

FieldValueIRS element (for citing)
NameKATHRYN LANCASTERName
TitleEXEC VP & CHIEF FINANCIAL OFFICERTitle
Date Signed2011-10-31DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone4159635100Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

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

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1ONE KAISER PLAZA 15LAddressLine1
CityOAKLANDCity
StateCAState
ZIP Code94612ZIPCode
FieldValueIRS element (for citing)
Gross Receipts26217133GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1998YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionCAMP BOWIE SERVICE CENTER PROVIDES MEMBERSHIP ACCOUNTING AND ADMINISTRATIVE SUPPORT SERVICES TO THE AFFILIATED EXEMPT ORGANIZATIONS THAT COMPRISE THE KAISER PERMANENTE MEDICAL CARE PROGRAM.ActivityOrMissionDescription
Nbr Voting Members Governing Body3NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees145TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year22993743ProgramServiceRevenuePriorYear
Program Service Revenue CY26091582ProgramServiceRevenueCY
Investment Income Prior Year20707InvestmentIncomePriorYear
Investment Income Current Year125551InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year23014450TotalRevenuePriorYear
Total Revenue Current Year26217133TotalRevenueCurrentYear
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 Year18048921SalariesEtcPriorYear
Salaries Etc Current Year6608553SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year13638630OtherExpensePriorYear
Other Expenses Current Year19340760OtherExpensesCurrentYear
Total Expenses Prior Year31687551TotalExpensesPriorYear
Total Expenses Current Year25949313TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-8673101RevenuesLessExpensesPriorYear
Revenues Less Expenses CY267820RevenuesLessExpensesCY
Total Assets BOY19239643TotalAssetsBOY
Total Assets EOY27706609TotalAssetsEOY
Total Liabilities BOY20878293TotalLiabilitiesBOY
Total Liabilities EOY29096512TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-1638650NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-1389903NetAssetsOrFundBalancesEOY
Mission DescriptionCAMP BOWIE SERVICE CENTER PROVIDES MEMBERSHIP ACCOUNTING AND ADMINISTRATIVE SUPPORT SERVICES TO THE AFFILIATED EXEMPT ORGANIZATIONS THAT COMPRISE THE KAISER PERMANENTE MEDICAL CARE PROGRAM.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense25949313Expense
Grants0Grants
Revenue26091582Revenue
DescriptionPROCESS INDIVIDUAL MEMBERSHIP RECORDS FOR THE MEMBERS OF THOSE AFFILIATED ORGANIZATIONS THAT COMPRISE THE KAISER PERMANENTE MEDICAL CARE PROGRAM.Description
Total Program Service Expense25949313TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees145NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members3NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledCOStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledTXStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonVP - NATIONAL TAX COMPLIANCENamePerson
Telephone Number5102716385TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ONE KAISER PLAZA 15LAddressLine1
CityOAKLANDCity
StateCAState
ZIP Code94612ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
ARTHUR SOUTHAM MD
DIRECTOR0.2X02020299353928
BERNARD TYSON
DIRECTOR1.0X01942514359961
DONNA LYNNE
DIRECTOR & CHAIR1.0X0820658182750
DEBORAH STOKES
SVP, CC & CAO0.30622642123860X
GERARD L COY
PRESIDENT50.0062744293206X
JENNIFER GARDNER
ASSISTANT SECRETARY0.5010324754938X
KATHRYN LANCASTER
EXECUTIVE VP, CFO1.001558076296474X
THOMAS R MEIER
SVP & TREASURER1.00647785107439X
VICTORIA B ZATKIN
SECRETARY0.5031136983647X
RUSS HEROLD
SR MANAGER ACCOUNTING50.0013057025970X
CHARLES KIRSCHBAUM
SR OPERATIONS MANAGER50.0010859118671X
CALVIN STRIGGLES
MANAGER - ACCOUNTING50.0010561524212X
BARBARA ISHIKAWA
DIR - MEMBERSHIP ADMIN50.0021062842755X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs9209436TotalReportableCompFrmRltdOrgs
Total Other Compensation1767811TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MATRIX RESOURCES INC
115 PERIMETER CENTER PLACE NE 25DUNWOODYGA30346O/S PERSONEL176758
KELLY SERVICES INC
PO BOX 530437ATLANTAGA30353O/S PERSONEL785698
FISERV OUTPUT SOLUTIONS
13100 N PROMENADE BLVDSTAFFORDTX77477PRINTING & DUPL. SVC818958
INSIGHT GLOBAL INC
4170 ASHFORD DUNWOODY RD 580ATLANTAGA30319O/S PERSONEL665763
SPHERION CORPORATION
1081 WESTWOOD BLVDLOS ANGELESCA90024O/S PERSONEL242224
FieldValueIRS element (for citing)
Number Of Contractors GT100 K6NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionMEMBERSHIP SERVICEDescription
Business Code561499BusinessCode
Total Revenue Column26091582TotalRevenueColumn
Related Or Exempt Function Income26091582RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue26091582TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column125551TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$125,551ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column26217133TotalRevenueColumn
Related Or Exempt Function Income26091582RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$125,551ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total4482435Total
Program Services4482435ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total120528Total
Program Services120528ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1556263Total
Program Services1556263ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total449327Total
Program Services449327ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total192004Total
Program Services192004ProgramServices

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total4455Total
Program Services4455ProgramServices

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total518842Total
Program Services518842ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total136661Total
Program Services136661ProgramServices

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total20710Total
Program Services20710ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total14633298Total
Program Services14633298ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1034495Total
Program Services1034495ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
OUTSIDE MEDICAL SERVICES18006821800682
EQUIPMENT RENTAL316388316388
NON-CAPITAL EQUIPMENT245951245951
OUTSIDE NON-MEDICAL SERVICES177110177110
SUPPLIES108449108449

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total151715Total
Program Services151715ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total25949313Total
Program Services25949313ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY11626BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY111414BOY
EOY68547EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis5025585LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1399969LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3179823BOY
EOY3625616EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY15936780BOY
EOY24012446EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY19239643BOY
EOY27706609EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2306676BOY
EOY827631EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY18571617BOY
EOY28268881EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY20878293BOY
EOY29096512EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY-1638650BOY
EOY-1389903EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-1638650BOY
EOY-1389903EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY19239643BOY
EOY27706609EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses267820ReconcilationRevenueExpenses
Reconcilation Other Changes-19073ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

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

Supported Org Information SupportedOrgInformation (5 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
KAISER FOUNDATION HEALTH PLAN INC
94134052309truetruetrue$3,727,362
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
93079803909truetruetrue$8,057,222
KASIER FOUNDATION HEALTH PLAN OF COLORADO
84059161709truetruetrue$8,512,310
KAISER FOUNDATION HEALTH PLAN OF GEORGIA
58159207609truetruetrue$3,712,768
KAISER FOUNDATION HEALTH PLAN OF OHIO
34092226809truetruetrue$2,091,335
FieldValueIRS element (for citing)
Total Number Of Supported Orgs5TotalNumberOfSupportedOrgs
Sum Of Amounts26100997SumOfAmounts
General ExplanationCamp Bowie provides membership accounting and administrative support to Kaiser Foundation Health Plan Inc and its subsidiariesGeneralExplanation

Schedule D IRS990ScheduleD

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

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis2756391OtherCostOrOtherBasis
Depreciation689098Depreciation
Book Value2067293BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2269194OtherCostOrOtherBasis
Depreciation710871Depreciation
Book Value1558323BookValue
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildings
Total Of Book Value Land Buildings3625616TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionDUE FROM AFFILIATED ORGDescription
Book Value24012446BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets24012446TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
ACCRUED PAYROLL TAXES/CHARGES$392,109
PENSION/BENEFIT PLAN PAYABLE$684,470
DUE TO AFFILIATES$26,393,220
LT DEFERRED RENT$799,082
FieldValueIRS element (for citing)
Total Of Amounts28268881TotalOfAmounts

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ARTHUR SOUTHAM MD
07352520124186104318603426220113060237422700
BERNARD TYSON
07378870118050002412703468930130680230247500
DEBORAH STOKES
0313713024955205937701107920130680746502040338
DONNA LYNNE
0393534040438402274001692390135110100340800
GERARD L COY
03403850270300016757081900011306072064800
JENNIFER GARDNER
0957180604001489041870013068015818500
KATHRYN LANCASTER
0615090091990002308602834060130680185455000
THOMAS R MEIER
03160760297094034615094371013068075522400
VICTORIA B ZATKIN
019657008017403462508176301884039501600
RUSS HEROLD
011709101183301646012459013511015654000
BARBARA ISHIKAWA
015590405192702797022183020572025338300

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierExplanationExplanation
Schedule J, Question 3Camp bowie service center relied on a related organization that used one or more of the methods described below to establish the top management officials' compensation: Compensation committee Independent compensation consultant Written employment contract Compensation survey or study, and Approval by the board or compensation committee
Schedule J, Question 4aListed persons participated in arrangements entitling them to severance benefits in the event of termination by the organization without cause or due to job elimination. Depending on position level, tenure, and termination reason, severance benefits payable under these arrangements provide for pay and health benefits continuation plus payment of accrued obligations. In addition, for some of the listed persons, severance benefits payable include prorated incentive awards for performance periods not yet ended. None of the listed persons participated in arrangements entitling them to change-of-control payments.
Schedule J, Question 4bKathryn Lancaster $ 368 Thomas Meier 609 Deborah Stokes 40,338 Some of the listed persons participated in nonqualified supplemental retirement plans. Under these plans, the organization makes annual contributions to accounts held in the name of individual participants. Contributions vary by position level and pay, and vest over time based on age and/or service. Participant accounts are credited with actual investment returns from up to four mutual funds and/or with a fixed rate of interest or a combination thereof. Unvested amounts are subject to risk of forfeiture.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (22 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Line 6Kaiser Foundation Health Plan, Inc is sole member
Form 990, Part VI, Line 7aKaiser Foundation Health Plan, Inc appoints the directors (and fills vacancies and has authority to remove directors)
Form 990, Part VI, Line 7bUpon dissolution, remaining assets shall first be distributed to Kaiser Foundation Health Plan, Inc and then to one or more organizations which are operated for hospital or charitable purposes.
Form 990, Part VI, Line 11bFORM 990 REVIEW PROCESS 1. KEY INFORMATION IS OBTAINED AND/OR CONFIRMED WITH INTERNAL SOURCES INCLUDING REGIONAL FINANCE AND EXECUTIVE COMPENSATION. 2. Prior to finalization, the return is reviewed with a KPMG tax advisor. 3. once signed by a KPMG tax advisor, the return and underlying data are reviewed by an officer or a member of management designated by an officer for signature and filing. 4. Copies are then provided to Board Members.
Form 990, Part VI, Line 12cRegularly and Consistently Monitors Compliance with the Conflicts of Interest Policy Kaiser Permanente regularly monitors compliance with the Conflicts of Interest Policy in 3 key ways: 1. The Kaiser Permanente Compliance Hotline is available to all employees and vendors to report actual or potential conflicts of interest. All calls are answered by a third party and provided to Kaiser Permanente's National Compliance Office for review and appropriate action. Employees can report anonymously. Retaliation is prohibited. Reports of actual or potential Conflicts of Interest are generated and investigations are conducted as required and information is tracked and trended to determine if additional guidance is required to avoid or manage conflicts of interest. Compliance Hotline Reports are provided for review and action to the Kaiser Foundation Health Plan/ Hospitals Boards of Directors annually. 2. Chief Compliance Officer and the SVP of Internal Audit Services annually review the directors', officers', key employees', and executives' Annual Conflicts of Interest Questionnaire disclosures and provide direction on any investigations required. Investigations are documented, tracked and trended to determine if additional controls or education is required; In addition, Conflicts of Interest Questionnaire reports are provided for review and action to the Kaiser Foundation Health Plan/ Hospitals Boards of Directors annually; and 3. Annually, as a component of the external audit, KPMG reviews the Annual Conflicts of Interest Questionnaires process completed by Directors, Officers, Key Employees, and Executives, and actions taken as a result of the disclosures. The results of the annual audit, including any findings in this area are presented to the Kaiser Foundation Health Plan/ Hospitals Audit and Compliance Committee. Regularly and Consistently Enforces Compliance with the Conflicts of Interest Policy To ensure consistency in the enforcement of the policy Kaiser Permanente uses the following steps as a general guideline: A. Represented employees are subject to any corrective/disciplinary action provisions described in specific regional/national collective bargaining agreements and/or organizational policies and practices. B. Kaiser Permanente informs employees of the National Human Resources Policy No. 14. Corrective/Disciplinary Action Policy during new employee orientation and in annual compliance training. C. In the event that it is necessary to discipline any employee because of, but not limited to, failure to comply with applicable legal/regulatory requirements, Kaiser Permanente policies and procedures, or the Principles of Responsibility, or for unsatisfactory performance or misconduct, coaching/counseling and/or corrective/disciplinary action may include, but is not limited to: - Oral discussion and/or warning by the employee's immediate supervisor or higher level manager to correct the problem - Written notice, with or without final warning - Paid or unpaid suspension, with or without final warning - Termination of employment
Form 990, Part VI, Line 15a/bThe executive compensation program as administered by Kaiser Foundation Health Plan, Inc is designed to recruit, retain and motivate qualified senior management personnel. Senior management personnel have a significant impact on the strategic and policy direction and results of the organization. Therefore, the executive compensation program is, to a significant degree, performance-based. The compensation program is reviewed annually by the Compensation Committee of the Board of Directors which evaluates and approves, prior to payment, all programs and payments to CEO, Executive Director and top management officials (executives). Base pay for executive positions is established at a level comparable to the relevant market. In addition, other components of the compensation program bear 'at-risk' features designed to focus on strategically important performance goals and to assist in attracting and retaining top performers. The executive compensation program is targeted at the median of the comparable external market in which the organization competes for executive leadership. Evaluation of comparable pay data is performed by an Independent Compensation, Benefit & Human Resource Consulting firm. The compensation program focuses on objectives in the areas of quality of member care and service, financial soundness, and the community and social mission of the organization.
Form 990, Part VI, Line 19Governing documents, Conflict of Interest Policy - are available upon request as disclosed to other regulatory bodies To request copies contact: Vice President - National Tax Compliance Kaiser Foundation Health Plan and Hospitals One Kaiser Plaza, Ste 15L Oakland, CA 94612
Form 990, Part VII, Section A, Column BIndividuals who are both officers and members of Boards of Directors work full time as employees as well as fulfill their board assignment. All officers work full time in their employee capacity. Full time work may require in excess of the traditional 40 hour week. Given the integrated nature of our organization, employees may provide support for various Kaiser Permanente companies. The average hours per week reported for the filing organization and related organizations was estimated.Hours for related organizations
Form 990, Part XI, Line 5Other changes in net assets or fund balances Change in Other Comprehensive Income <$19,073>
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:ARTHUR SOUTHAM, MD TITLE:DIRECTOR HOURS:50FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:BERNARD TYSON TITLE:DIRECTOR HOURS:49FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:DONNA LYNNE TITLE:DIRECTOR & CHAIR HOURS:49FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:DEBORAH STOKES TITLE:SVP, CC & CAO HOURS:50FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:GERARD L COY TITLE:PRESIDENT HOURS:FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:JENNIFER GARDNER TITLE:ASSISTANT SECRETARY HOURS:50FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:KATHRYN LANCASTER TITLE:EXECUTIVE VP, CFO HOURS:49FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:THOMAS R MEIER TITLE:SVP & TREASURER HOURS:49FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:VICTORIA B ZATKIN TITLE:SECRETARY HOURS:50FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:RUSS HEROLD TITLE:SR MANAGER ACCOUNTING HOURS:FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:CHARLES KIRSCHBAUM TITLE:SR OPERATIONS MANAGER HOURS:FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:CALVIN STRIGGLES TITLE:MANAGER - ACCOUNTING HOURS:FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:BARBARA ISHIKAWA TITLE:DIR - MEMBERSHIP ADMIN HOURS:FORM 990 PART VII

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (14 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
KAISER FOUNDATION HEALTH PLAN INC
ONE KAISER PLAZA 15LOAKLANDCA94612941340523HEALTH CARECA501(c)(3)9NA
KAISER FOUNDATION HEALTH PLAN OF CO INC
ONE KAISER PLAZA 15LOAKLANDCA94612840591617HEALTH CARECO501(c)(3)9KFHP INC
KAISER FOUNDATION HEALTH PLAN OF GA INC
ONE KAISER PLAZA 15LOAKLAND CACA94612581592076HEALTH CAREGA501(c)(3)9KFHP INC
KAISER FOUNDATION HEALTH PLAN OF THE NW
ONE KAISER PLAZA 15LOAKLANDCA94612930798039HEALTH CAREOR501(c)(3)9KFHP INC
KAISER FOUNDATION HEALTH PLAN OF OH INC
ONE KAISER PLAZA 15LOAKLANDCA94612340922268HEALTH CAREOH501(c)(3)9KFHP INC
KAISER FOUNDATION HOSPITALS
ONE KAISER PLAZA 15LOAKLANDCA94612941105628HEALTH CARECA501(c)(3)3KFHP INC
KAISER FOUNDATION HEALTH PLAN OF THE MAS
ONE KAISER PLAZA 15LOAKLANDCA94612520954463HEALTH CAREMD501(c)(3)9KFHP INC
KAISER HEALTH ALTERNATIVES
ONE KAISER PLAZA 15LOAKLANDCA94612930954562HEALTH CAREOR501(c)(3)9KFHP INC
KAISER HOSPITAL ASSET MANAGEMENT INC
ONE KAISER PLAZA 15LOAKLANDCA94612943299125ASSET MGMTCA501(c)(3)11KF HOSPITALS
KAISER HEALTH PLAN ASSET MANAGEMENT INC
ONE KAISER PLAZA 15LOAKLANDCA94612943299124ASSET MGMTCA501(c)(3)11KFHP INC
LOKAHI ASSURANCE LTD
ONE KAISER PLAZA 15LOAKLANDCA94612912171891WC PlacementHI501(c)(3)11KFHP INC
OHP
ONE KAISER PLAZA 15LOAKLANDCA94612930480268LEASINGWA501(c)(3)11KFHP INC
1800 HARRISON FOUNDATION
ONE KAISER PLAZA 15LOAKLANDCA94612943317484FINANCINGCA501(c)(3)11KFHP INC
KAISER HOSPITAL ASSISTANCE CORPORATION
ONE KAISER PLAZA 15LOAKLANDCA94612311779500FINANCINGCA501(C)(3)11KF HOSPITALS

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1HEALTH CARE MANAGEMENT SOLUTIONS LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ONE KAISER PLAZA 15LAddressLine1
CityOAKLANDCity
StateCAState
ZIP Code94612ZIPCode
FieldValueIRS element (for citing)
EIN203924985EIN
Primary ActivityCONSULTINGPrimaryActivity
Legal Domicile StateCALegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeN/APredominantIncomeType
Share Of Total Income0ShareOfTotalIncome
Share Of EOY Assets0ShareOfEOYAssets
Code V$0CodeVAmount
Percentage Ownership0.00000PercentageOwnership

Form990 Schedule R Part IV Form990ScheduleRPartIV (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateType Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
ARCHIMEDES INC
ONE KAISER PLAZA 15LOAKLANDCA94612203774729CONSULTINGCAC CORP000.00000
KAISER PERMANENTE INTERNATIONAL
ONE KAISER PLAZA 15LOAKLANDCA94612943245176CONSULTINGCAC CORP000.00000
KAISER PERMANENTE INSURANCE COMPANY
ONE KAISER PLAZA 15LOAKLANDCA94612943203402INSURANCECAC CORP000.00000
KAISER PROPERTIES SERVICES INC
ONE KAISER PLAZA 15LOAKLANDCA94612943259432REAL ESTATECAC CORP000.00000
OAK TREE ASSURANCE LTD
ONE KAISER PLAZA 15LOAKLANDCA94612030329760INSURANCEVTC CORP000.00000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg