SCAN HEALTH PLAN ARIZONA: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- SCAN HEALTH PLAN ARIZONA (EIN 73-1729007)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-11
- IRS object ID
- 201143159349302434
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-11T11:16:06-06:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 655 WEST BROADWAY SUITE 700 | AddressLine1 |
| City | SAN DIEGO | City |
| State | CA | State |
| ZIP Code | 921018590 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 731729007 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SCAN HEALTH PLAN ARIZONA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SCAN | NameControl |
| Phone | 5629895100 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3800 KILROY AIRPORT WAY NO 100 | AddressLine1 |
| City | LONG BEACH | City |
| State | CA | State |
| ZIP Code | 908065616 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DAVID J SCHMIDT | Name |
| Title | CEO | Title |
| Phone | 5629895100 | Phone |
| Date Signed | 2011-11-10 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DIANA J MCCUTCHEN | Name |
| Phone | 6192326500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | ELIZABETH RUSSELL | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3800 KILROY AIRPORT WAY NO 100 | AddressLine1 |
| City | LONG BEACH | City |
| State | CA | State |
| ZIP Code | 908065616 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 58085586 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.SCANHEALTHPLAN.COM/ARIZONA/MEDICARE/ | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2006 | YearFormation |
| State Legal Domicile | AZ | StateLegalDomicile |
| Activity Or Mission Description | TO SERVE AND TO IMPROVE THE LIVES OF THE FRAIL, ELDERLY AND DISABLED RESIDENTS OF ARIZONA. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 2 | NbrIndependentVotingMembers |
| Total Nbr Employees | 167 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 29621602 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 57916933 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 113011 | InvestmentIncomePriorYear |
| Investment Income Current Year | 168653 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 29734613 | TotalRevenuePriorYear |
| Total Revenue Current Year | 58085586 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 1181894 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 2026901 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 35265228 | OtherExpensePriorYear |
| Other Expenses Current Year | 112927247 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 36447122 | TotalExpensesPriorYear |
| Total Expenses Current Year | 114954148 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -6712509 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -56868562 | RevenuesLessExpensesCY |
| Total Assets BOY | 30130639 | TotalAssetsBOY |
| Total Assets EOY | 39787805 | TotalAssetsEOY |
| Total Liabilities BOY | 12954781 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 59440555 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 17175858 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -19652750 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO SERVE AND IMPROVE THE LIVES OF THE FRAIL, ELDERLY AND DISABLED RESIDENTS OF ARIZONA BY PROVIDING MEDICAL AND PHARMACY SERVICES, COORDINATED CARE, SOCIAL SERVICES AND OTHER SERVICES TO A GERIATRIC AND DISABLED POPULATION THAT IS UNDERSERVED AND AT RISK. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 106119965 | Expense |
| Revenue | 57916933 | Revenue |
| Description | THE ARIZONA COMPANIES, SCAN HEALTH PLAN ARIZONA, A MEDICARE ADVANTAGE CONTRACTOR, AND SCAN LONG TERM CARE, A PROGRAM CONTRACTOR TO THE ARIZONA LONG TERM CARE SYSTEM (ALTCS) COMPONENT OF THE ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM (AHCCCS), THE STATE MEDICAID PROGRAM, ARE NON-PROFIT MANAGED CARE ORGANIZATIONS THAT WERE CREATED TO SERVE THE HEALTH CARE AND INDEPENDENCE NEEDS OF THE SENIOR AND PHYSICALLY DISABLED CITIZENS OF MARICOPA COUNTY, ARIZONA. THE SHARED MISSION OF THE ARIZONA COMPANIES IS TO FIND INNOVATIVE WAYS TO ENHANCE THE BENEFICIARIES' ABILITY TO MANAGE THEIR HEALTH AND EXERT CONTROL OVER WHERE AND HOW THEY LIVE. WE WILL ACHIEVE THAT MISSION BY DEVELOPING PARTNERSHIPS THAT ALLOW US TO DELIVER THE RIGHT HEALTH CARE, IN THE RIGHT SETTING, AND AT THE RIGHT COST WHILE MAXIMIZING THE MEMBERS' ABILITY TO REMAIN AS INDEPENDENT AS POSSIBLE. OUR GOAL IS TO BECOME THE LEADING GERIATRIC AND PHYSICALLY DISABLED HEALTH MANAGEMENT ENTERPRISE IN MARICOPA COUNTY.SCAN LONG TERM CARE WAS SELECTED AS AN ALTCS PROGRAM CONTRACTOR IN MAY, 2006 AND BEGAN PROGRAM OPERATIONS ON OCTOBER 1, 2006. THE PLAN IS RESPONSIBLE FOR ARRANGING, MANAGING AND MONITORING THE FULL RANGE OF HEALTH CARE SERVICES (PHYSICIAN, HOSPITAL, LAB, RADIOLOGY, DURABLE MEDICAL EQUIPMENT, ETC.), NOT OTHERWISE COVERED BY MEDICARE, HOME CARE SERVICES AND RESIDENTIAL CARE SERVICES REQUIRED BY THE ALTCS BENEFICIARIES ENROLLED IN SCAN. THE ALTCS PROGRAM IS DESIGN TO SERVE THE NEEDS OF LOW INCOME ARIZONA CITIZENS AGE 65 OR OLDER, BLIND OR DISABLED AND IN NEED OF LONG TERM CARE SERVICES. SCAN LONG TERM CARE BEGAN THE PROGRAM WITH 164 ENROLLEES AND CURRENTLY SERVES MORE THAN 2,910 ALTCS BENEFICIARIES IN MARICOPA COUNTY. THE ALTCS PROGRAM IS PRINCIPALLY BUILT ON A FOUNDATION OF DIRECT CASE MANAGEMENT SERVICE COORDINATION FOR EACH ENROLLEE. SCAN LONG TERM CARE CURRENTLY HAS A TEAM OF MORE THAN FIFTY CASE MANAGERS SERVING THE ALTCS ENROLLEES.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 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 8,461 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 100% 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 $498 MILLION OF DIRECT CARE SERVICES FOR THESE MEDICARE AND MEDICAID ENROLLEES. OF THE TOTAL AMOUNT PAID FOR MEDICAL AND RESIDENTIAL SERVICES, APPROXIMATELY 40.6% WERE DIRECTED TO LONG TERM CARE RESIDENTIAL SERVICE PROVIDERS, 24.0% WERE DIRECTED TO HOME AND COMMUNITY BASED SERVICE PROVIDERS, AND 32.6% WERE DIRECTED TO MEDICAL SERVICE PROVIDERS AND THE REMAINING 2.8% WERE DIRECTED TO CASE MANAGEMENT COORDINATION SERVICES. | Description |
| Total Program Service Expense | 106119965 | TotalProgramServiceExpense |
| Described In501 C3 | 0 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 1872 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 167 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 2 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | AZ | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RAJEEV NARULA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5629895100 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3800 KILROY AIRPORT WAY | AddressLine1 |
| City | LONG BEACH | City |
| State | CA | State |
| ZIP Code | 90806 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| DOUGLAS JAQUES | ||||||||
| DIRECTOR, SECRETARY | 0.40 | X | X | 0 | 400281 | 74806 | ||
| DAVID SCHMIDT | ||||||||
| OUTGOING CHAIRMAN | 0.40 | X | 0 | 3052208 | 32940 | |||
| TIMOTHY SCHWAB MD | ||||||||
| DIRECTOR | 0.40 | X | 0 | 828269 | 20761 | |||
| HENRY W OSOWSKI | ||||||||
| DIRECTOR | 0.40 | X | 0 | 413288 | 39822 | |||
| LINDA STRIKE | ||||||||
| DIRECTOR | 0.60 | X | 0 | 112156 | 0 | |||
| DENNIS EDER | ||||||||
| DIRECTOR | 0.40 | X | 0 | 539644 | 80366 | |||
| LEONARD KIRSCHNER | ||||||||
| DIRECTOR | 0.40 | X | 0 | 27000 | 0 | |||
| RYAN TRIMBLE | ||||||||
| INTERIM CHAIRMAN | 0.40 | X | 0 | 163786 | 876 | |||
| THOMAS LESCAULT | ||||||||
| PRESIDENT | 40.00 | X | 382686 | 0 | 46210 | |||
| RAJEEV NARULA | ||||||||
| CHIEF FINANCIAL OFFICER | 5.00 | X | 0 | 301295 | 22805 | |||
| ELIZABETH RUSSELL | ||||||||
| INTERIM CEO | 5.00 | X | 0 | 419996 | 68191 | |||
| MARC LATO | ||||||||
| MEDICAL DIRECTOR | 40.00 | 275966 | 0 | 34441 | X | |||
| MAUREEN MCGURRIN | ||||||||
| VP-OPERATIONS | 40.00 | 229461 | 0 | 22596 | X | |||
| REBECCA LEARNER | ||||||||
| SR. VP- COMPLIANCE | 40.00 | 0 | 303947 | 47280 | X | |||
| JOEY ZEPEDA | ||||||||
| VP-CASE MANAGEMENT | 40.00 | 149332 | 0 | 29974 | X | |||
| RICHARD PEITZMEIER | ||||||||
| DIRECTOR SALES | 40.00 | 141472 | 0 | 8142 | X | |||
| TINA GRAHAM | ||||||||
| VP-COMPLIANCE | 40.00 | 170145 | 0 | 12128 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1349062 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 6561870 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 541338 | TotalOtherCompensation |
| Number Individuals GT100 K | 10 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| EXPRESS SCRIPTS INC | |||||
| 21653 NETWORK PLACE | CHICAGO | IL | 606731216 | MEDICAL SERVICES | 16090237 |
| SCOTTSDALE HEALTHCARE HOSPITALS | |||||
| PO BOX 29682 | PHOENIX | AZ | 850389682 | MEDICAL SERVICES | 3210088 |
| BANNER BAYWOOD MEDICAL CENTER | |||||
| PO BOX 2978 | PHOENIX | AZ | 85062 | MEDICAL SERVICES | 3161607 |
| BANNER BOSWELL MED CTR | |||||
| P O BOX 29693 | PHOENIX | AZ | 850389693 | MEDICAL SERVICES | 3155416 |
| BANNER GOOD SAM MEDICAL | |||||
| PO BOX 2978 | PHOENIX | AZ | 850722978 | MEDICAL SERVICES | 3064574 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 118 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| MEDICARE PREMIUM | 900099 | 88242416 | 88242416 |
| PREMIUM DEFICIENCY RES | 900099 | -30325483 | -30325483 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 57916933 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 168653 | TotalRevenueColumn |
| Exclusion | $168,653 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 58085586 | TotalRevenueColumn |
| Related Or Exempt Function Income | 57916933 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $168,653 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 219872 | Total |
| Management And General | 219872 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1448798 | Total |
| Program Services | 507636 | ProgramServices |
| Management And General | 941162 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 105672 | Total |
| Program Services | 19391 | ProgramServices |
| Management And General | 86281 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 137522 | Total |
| Program Services | 46651 | ProgramServices |
| Management And General | 90871 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 115037 | Total |
| Program Services | 38021 | ProgramServices |
| Management And General | 77016 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3568004 | Total |
| Program Services | 346645 | ProgramServices |
| Management And General | 3221359 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36423 | Total |
| Management And General | 36423 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 76400 | Total |
| Management And General | 76400 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14737 | Total |
| Management And General | 14737 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1480637 | Total |
| Program Services | 119654 | ProgramServices |
| Management And General | 1360983 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2423529 | Total |
| Program Services | 5738 | ProgramServices |
| Management And General | 2417791 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 53034 | Total |
| Program Services | 3608 | ProgramServices |
| Management And General | 49426 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2963 | Total |
| Management And General | 2963 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 87326 | Total |
| Management And General | 87326 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 62996 | Total |
| Program Services | 3368 | ProgramServices |
| Management And General | 59628 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5884 | Total |
| Program Services | 391 | ProgramServices |
| Management And General | 5493 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 42196 | Total |
| Program Services | 18594 | ProgramServices |
| Management And General | 23602 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| MED SVCS FOR ELDERLY | 104994482 | 104994482 | 0 | 0 |
| OFFICE EQUIPMENT | 19559 | 2859 | 16700 | |
| TELECOMMUNICATIONS | 17987 | 3940 | 14047 | 0 |
| EMPLOYEE RECOGNITION | 14799 | 194 | 14605 | 0 |
| LICENSE & PERMITS | 13993 | 8743 | 5250 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12298 | Total |
| Program Services | 50 | ProgramServices |
| Management And General | 12248 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 114954148 | Total |
| Program Services | 106119965 | ProgramServices |
| Management And General | 8834183 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15528138 | BOY |
| EOY | 24996948 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18597 | BOY |
| EOY | 14253 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1415457 | BOY |
| EOY | 1307583 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 121853 | BOY |
| EOY | 62594 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1893599 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1193434 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 650989 | BOY |
| EOY | 700165 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11093135 | BOY |
| EOY | 11113886 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1302470 | BOY |
| EOY | 1592376 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30130639 | BOY |
| EOY | 39787805 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12569757 | BOY |
| EOY | 59042786 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 195974 | BOY |
| EOY | 105152 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 189050 | BOY |
| EOY | 292617 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12954781 | BOY |
| EOY | 59440555 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17175858 | BOY |
| EOY | -19652750 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17175858 | BOY |
| EOY | -19652750 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30130639 | BOY |
| EOY | 39787805 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -56868562 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 20039954 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 883637 | OtherCostOrOtherBasis |
| Depreciation | 534353 | Depreciation |
| Book Value | 349284 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1009962 | OtherCostOrOtherBasis |
| Depreciation | 659081 | Depreciation |
| Book Value | 350881 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 700165 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (2 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| INVESTMENT IN SCAN LONG TERM CARE | 9500000 | C |
| OTHER RESTRICTED INVESTEMENTS | 1613886 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 11113886 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DEFERRED COMPENSATION | Description |
| Amount | $292,617 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 292617 | TotalOfAmounts |
| Total Revenue | 58085586 | TotalRevenue |
| Total Expenses | 114954148 | TotalExpenses |
| Excess Or Deficit For Year | -56868562 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 39954 | NetUnrealizedGLOnInvestments |
| Other | $20,000,000 | OtherAmount |
| Total Adjustments | 20039954 | TotalAdjustments |
| Excess Or Deficit Per FS | -36828608 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 88451023 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 39954 | NetUnrealizedGainsInvestments |
| Other Revenues | 30325483 | OtherRevenues |
| Revenue Not Rptd F990 | 30365437 | RevenueNotRptdF990 |
| Revenue Subtotal | 58085586 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 58085586 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 145279631 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 30325483 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 30325483 | ExpensesNotRptdF990 |
| Expenses Subtotal | 114954148 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 114954148 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | CAPITAL CONTRIBUTION FROM RELATED TAX-EXEMPT ORGANIZATION 20,000,000. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | PREMIUM DEFICIENCY RESERVE - NETTED WITH REVENUE 30,325,483. |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | PREMIUM DEFICIENCY RESERVE 30,325,483. |
| PART X, FIN 48 FOOTNOTE TO FINANCIAL STATEMENTS: 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. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 1 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DOUGLAS JAQUES | |||||||||||||
| 0 | 281461 | 0 | 100810 | 0 | 18010 | 0 | 40540 | 0 | 34266 | 0 | 475087 | 0 | 0 |
| DAVID SCHMIDT | |||||||||||||
| 0 | 662524 | 0 | 285732 | 0 | 2103952 | 0 | 17150 | 0 | 15790 | 0 | 3085148 | 0 | 121631 |
| TIMOTHY SCHWAB MD | |||||||||||||
| 0 | 358125 | 0 | 185365 | 0 | 284779 | 0 | 17150 | 0 | 3611 | 0 | 849030 | 0 | 262798 |
| HENRY W OSOWSKI | |||||||||||||
| 0 | 267542 | 0 | 100441 | 0 | 45305 | 0 | 17150 | 0 | 22672 | 0 | 453110 | 0 | 24821 |
| DENNIS EDER | |||||||||||||
| 0 | 358891 | 0 | 160682 | 0 | 20071 | 0 | 53792 | 0 | 26574 | 0 | 620010 | 0 | 0 |
| RYAN TRIMBLE | |||||||||||||
| 0 | 89634 | 0 | 0 | 0 | 74152 | 0 | 0 | 0 | 876 | 0 | 164662 | 0 | 0 |
| THOMAS LESCAULT | |||||||||||||
| 297806 | 0 | 64681 | 0 | 20199 | 0 | 32334 | 0 | 13876 | 0 | 428896 | 0 | 0 | 0 |
| RAJEEV NARULA | |||||||||||||
| 0 | 233664 | 0 | 51977 | 0 | 15654 | 0 | 17150 | 0 | 5655 | 0 | 324100 | 0 | 0 |
| ELIZABETH RUSSELL | |||||||||||||
| 0 | 289006 | 0 | 111459 | 0 | 19531 | 0 | 41900 | 0 | 26291 | 0 | 488187 | 0 | 0 |
| MARC LATO | |||||||||||||
| 209057 | 0 | 50507 | 0 | 16402 | 0 | 17150 | 0 | 17291 | 0 | 310407 | 0 | 0 | 0 |
| MAUREEN MCGURRIN | |||||||||||||
| 175681 | 0 | 41303 | 0 | 12477 | 0 | 15272 | 0 | 7324 | 0 | 252057 | 0 | 0 | 0 |
| REBECCA LEARNER | |||||||||||||
| 0 | 211933 | 0 | 74781 | 0 | 17233 | 0 | 30056 | 0 | 17224 | 0 | 351227 | 0 | 0 |
| JOEY ZEPEDA | |||||||||||||
| 114982 | 0 | 26740 | 0 | 7610 | 0 | 10361 | 0 | 19613 | 0 | 179306 | 0 | 0 | 0 |
| TINA GRAHAM | |||||||||||||
| 131089 | 0 | 30711 | 0 | 8345 | 0 | 11326 | 0 | 802 | 0 | 182273 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINES 4A-C | ReturnReference |
| Explanation | PART I, LINE 4A: DURING 2010, THE EMPLOYMENT RELATIONSHIP OF DAVID SCHMIDT, CEO, WITH SCAN HEALTH PLAN AND SCAN GROUP WAS ENDED. IN CONNECTION WITH THE TERMINATION OF MR. SCHMIDT'S EMPLOYMENT, SCAN HEALTH PLAN NEGOTIATED AND PAID SEVERANCE TO MR. SCHMIDT THAT WAS IN ACCORDANCE WITH THE TERMS OF HIS THEN EXISTING EMPLOYMENT AGREEMENT. PART I, LINE 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 2010: DAVID SCHMIDT, DENNIS EDER, TIMOTHY SCHWAB, DOUGLAS JAQUES, HENRY OSOWSKI, AND THOMAS LESCAULT. 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. THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS OUT OF THE SECTION 457(F) PLAN DURING THE YEAR: (1) TIMOTHY SCHWAB, $262,798, (2) DAVID SCHMIDT, $121,631, AND (3) HENRY OSOWSKI $24,821. PART I, LINE 4C: THE FOLLOWING INDIVIDUALS PARTICIPATED IN SCAN HEALTH PLAN'S KEYSOP PLAN DURING THE TAXABLE YEAR: TIMOTHY SCHWAB AND REBECCA LEARNER. THE PLAN IS NOW FROZEN AND NO EMPLOYEES ARE BEING NEWLY ADDED AS PARTICIPANTS. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE ORGANIZATION IS SCAN GROUP, A CALIFORNIA NONPROFIT CORPORATION. | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE MEMBER HAS THE POWER TO APPOINT THE MEMBERS OF THE BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS PREPARED BY DELOITTE TAX LLP, WORKING IN CONJUNCTION WITH SCAN'S FINANCE DEPARTMENT. SCAN HEALTH PLAN'S ACCOUNTING MANAGER HAS DIRECT RESPONSIBILITY FOR THIS EFFORT, SUBJECT TO SUPERVISION BY THE SCAN HEALTH PLAN ARIZONA'S CHIEF FINANCIAL OFFICER. AFTER AN INITIAL DRAFT OF THE FORM 990 IS PREPARED, IT IS CIRCULATED FOR REVIEW AND COMMENT BY RELEVANT MEMBERS OF THE EXECUTIVE TEAM WHO HAVE RESPONSIBILITY AND/OR KNOWLEDGE ABOUT THE VARIOUS MATTERS DISCLOSED AND/OR DESCRIBED IN THE FORM. THE GENERAL COUNSEL, IN PARTICULAR, REVIEWS THE FORM 990 AND ENSURES ACCURACY OF DESCRIPTIONS AND THAT DISCLOSURE IS COMPLETE. THE DRAFT FORM 990 IS REVIEWED BY THE AUDIT 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. | |
| SCAN HEALTH PLAN ARIZONA REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY THROUGH ANNUAL CIRCULATION OF A CONFLICT OF INTEREST QUESTIONNAIRE WHICH IS REQUIRED TO BE ANSWERED BY ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS AND MEMBERS OF EXECUTIVE MANAGEMENT. IN ADDITION, THERE IS REGULAR EDUCATION AND ENFORCEMENT THROUGH OVERSIGHT OF SUCH POLICY AND THE SCAN HEALTH PLAN ARIZONA GIFT AND BUSINESS COURTESIES POLICY WITH RESPECT TO EACH DEPARTMENT BY MEMBERS OF THE SENIOR EXECUTIVE TEAM WITH RESPONSIBILITY FOR SUCH DEPARTMENT. THE LEGAL DEPARTMENT OF SCAN GROUP REVIEWS ALL CONTRACTUAL RELATIONSHIPS ENTERED INTO BY THE ORGANIZATION AND THE GENERAL COUNSEL OF SCAN GROUP IS RESPONSIBLE FOR MONITORING CONFLICTS OF INTEREST THROUGH THE ANNUAL CIRCULATION AND REVIEW OF THE CONFLICT OF INTEREST QUESTIONNAIRE. ACCORDINGLY, THE LEGAL DEPARTMENT OF SCAN GROUP THROUGH THE GENERAL COUNSEL IS IN A POSITION TO MONITOR AND ENFORCE COMPLIANCE WITH THE POLICY ON AN ONGOING BASIS. | FORM 990, PART VI, SECTION B, LINE 12C | |
| 15A: THE PROCESS FOR DETERMINING THE COMPENSATION OF THE PRESIDENT OF SCAN HEALTH PLAN ARIZONA IS CONDUCTED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF SCAN HEALTH PLAN ARIZONA, ALL OF THE VOTING MEMBERS OF WHICH ARE INDEPENDENT PERSONS. IN DETERMINING THE PRESIDENT'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 PRESIDENT'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 PRESIDENT'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 COMPENSATION COMMITTEE OF SCAN HEALTH PLAN ARIZONA DELIBERATES ON AND THEN VOTES ON SUCH RECOMMENDATION; THE PRESIDENT 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 PRESIDENT. 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 B, LINE 15 | |
| SCAN HEALTH PLAN ARIZONA'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. SCAN HEALTH PLAN ARIZONA'S AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE FROM THE ARIZONA DEPARTMENT OF INSURANCE FOR A NOMINAL FEE. | FORM 990, PART VI, SECTION C, LINE 19 | |
| RYAN TRIMBLE SERVED AS A BOARD MEMBER BETWEEN JANUARY 1, 2010 AND NOVEMBER 6, 2010. HE WAS COMPENSATED $74,152 AND RECEIVED A FORM 1099 REPORTING HIS COMPENSATION FROM SERVICES AS A BOARD MEMBER. ON NOVEMBER 7, 2010 HE ASSUMED THE ROLE OF INTERIM CEO OF SCAN HEALTH PLAN AND SCAN GROUP AND WAS COMPENSATED $89,634 AS AN EMPLOYEE OF THE ORGANIZATION AND RECEIVED A FORM W-2 FROM SCAN HEALTH PLAN FOR HIS SERVICES AS SUCH. 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 SCAN HEALTH PLAN ARIZONA ONLY. BELOW IS A BREAKDOWN OF HOURS SPENT PER AFFILIATE. THE FOLLOWING OFFICERS, KEY EMPLOYEES, AND BOARD MEMBERS OF SCAN HEALTH PLAN ARIZONA ALSO DEVOTE THE FOLLOWING TIME TO SCAN HEALTH PLAN: LINDA STRIKE - 0.8 HOURS PER WEEK DAVID SCHMIDT - 40.0 HOURS PER WEEK DENNIS EDER - 40.0 HOURS PER WEEK DOUGLAS JAQUES - 40.0 HOURS PER WEEK TIMOTHY SCHWAB - 40.0 HOURS PER WEEK RAJEEV NARULA - 40.0 HOURS PER WEEK HENRY W. OSOWSKI - 40.0 HOURS PER WEEK RYAN TRIMBLE - 40.0 HOURS PER WEEK REBECCA LEARNER - 40.0 HOURS PER WEEK ELIZABETH RUSSELL - 40.0 HOURS PER WEEK THE FOLLOWING OFFICERS, KEY EMPLOYEES, AND BOARD MEMBERS OF SCAN HEALTH PLAN ARIZONA ALSO DEVOTE THE FOLLOWING TIME TO SCAN GROUP: DAVID SCHMIDT - 40.0 HOURS PER WEEK DENNIS EDER - 40.0 HOURS PER WEEK HENRY W. OSOWSKI - 40.0 HOURS PER WEEK LINDA STRIKE - 7.1 HOURS PER WEEK TIMOTHY SCHWAB - 40.0 HOURS PER WEEK DOUGLAS JAQUES - 40.0 HOURS PER WEEK RYAN TRIMBLE - 40.0 HOURS PER WEEK REBECCA LEARNER - 40.0 HOURS PER WEEK ELIZABETH RUSSELL - 40.0 HOURS PER WEEK 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: DAVID SCHMIDT DENNIS EDER RAJEEV NARULA DOUGLAS JAQUES HENRY W. OSOWSKI TIMOTHY SCHWAB RYAN TRIMBLE REBECCA LEARNER ELIZABETH RUSSELL THE FOLLOWING OFFICERS, KEY EMPLOYEES, AND BOARD MEMBERS OF SCAN HEALTH PLAN ARIZONA ALSO DEVOTE THE FOLLOWING TIME TO SCAN FOUNDATION: DAVID SCHMIDT - 1.5 HOURS PER WEEK DENNIS EDER - 2.0 HOURS PER WEEK DOUGLAS JAQUES - 2.0 HOURS PER WEEK LINDA STRIKE - 2.0 HOURS PER WEEK RYAN TRIMBLE - 1.5 HOURS PER WEEK THE FOLLOWING OFFICERS, KEY EMPLOYEES, AND BOARD MEMBERS OF SCAN HEALTH PLAN ARIZONA ALSO DEVOTE THE FOLLOWING TIME TO SCAN LONG TERM CARE: TIMOTHY SCHWAB - 0.4 HOURS PER WEEK DAVID SCHMIDT - 0.4 HOURS PER WEEK DENNIS EDER - 0.4 HOURS PER WEEK DOUGLAS JAQUES - 0.4 HOURS PER WEEK LINDA STRIKE - 0.6 HOURS PER WEEK HENRY W. OSOWSKI - 0.4 HOURS PER WEEK LEONARD KIRSCHNER - 0.4 HOURS PER WEEK RYAN TRIMBLE - 0.4 HOURS PER WEEK RAJEEV NARULA - 5.0 HOURS PER WEEK ELIZABETH RUSSELL - 5.0 HOURS PER WEEK THE 40 HOURS PER WEEK DISCLOSED IN COLUMN B FOR THOMAS LESCAULT, MARC LATO, MAUREEN MCGURRIN, TINA GRAHAM, JOEY ZEPEDA, AND RICHARD PEITZMEIER ARE SPLIT BETWEEN SCAN HEALTH PLAN ARIZONA AND SCAN LONG TERM CARE. | FORM 990, PART VII: | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | NET UNREALIZED GAINS ON INVESTMENTS: 39,954. CAPITAL CONTRIBUTION FROM RELATED TAX-EXEMPT ORGANIZATION 20,000,000. TOTAL TO FORM 990, PART XI, LINE 5: 20,039,954. | FORM 990, PART XI, LINE 5: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| SCAN HEALTH PLAN | |||||||||||
| 3800 KILROY AIRPORT WAY | LONG BEACH | CA | 90806 | 953858259 | MEDICARE ADVANTAGE | CA | 501 (C)(3) | LINE 9 | SCAN GROUP | 0 | |
| THE SCAN FOUNDATION | |||||||||||
| 3800 KILROY AIRPORT WAY | LONG BEACH | CA | 90806 | 450552845 | GRANT MAKING | CA | 501 (C)(3) | LINE 11, TYPE II | SCAN GROUP | 0 | |
| SCAN LONG TERM CARE | |||||||||||
| 3800 KILROY AIRPORT WAY | LONG BEACH | CA | 90806 | 204607594 | MEDICAID MGMT. CARE | AZ | 501 (C)(4) | SCAN HEALTH PLAN ARIZONA | 1 | ||
| SCAN GROUP | |||||||||||
| 3800 KILROY AIRPORT WAY | LONG BEACH | CA | 90806 | 953826037 | ADMIN. SUPPORT | CA | 501 (C)(3) | LINE 11, TYPE II | 0 | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| SCAN LONG TERM CARE | ||
| P | 989405 | SEE PART VII |
| SCAN HEALTH PLAN | ||
| O | 1666318 | SEE PART VII |
| SCAN GROUP | ||
| O | 1910375 | SEE PART VII |
| SCAN LONG TERM CARE | ||
| N | 9475689 | SEE PART VII |
| SCAN GROUP | ||
| C | 20000000 | CAPITAL CONTRIBUTION - CASH |
| SCAN LONG TERM CARE | ||
| M | 325000 | SEE PART VII |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | SCHEDULE R, PART VII | ReturnReference |
| Explanation | THE PERCENTAGE OF ALLOCATION TO AFFILIATED COMPANIES IS DETERMINED BASED ON ESTIMATED PERCENTAGE OF TIME WORKED, PERCENTAGE OF HEADCOUNTS, AND THE PERCENTAGE OF SCAN MEMBERSHIP, AS APPROPRIATE BASED ON THE NATURE OF THE EXPENSE. | Explanation |