2022-11-14T15:05:22-06:00 2021-12-31 861065772 DELOITTE TAX LLP 50 SOUTH SIXTH STREET MINNEAPOLIS MN 55402 990 2021-07-20 871858798 HEALTHCARE IN ACTION INC HEAL 5629895100 3800 KILROY AIRPORT WAY 100 LONG BEACH CA 90806 MICHAEL HOCHMAN CEO & PRESIDENT 5629895100 2022-11-09 1 MICHAEL HOCHMAN 999009999 ANNA KOLAKALURI P01275237 6123974000 0 AAL1 IAL1 2021 2022-09-23 18:48:47Z X MICHAEL HOCHMAN 3800 KILROY AIRPORT WAY 100 LONG BEACH CA 90806 2030000 0 X WWW.HEALTHCAREINACTION.ORG X 2021 CA TO IMPROVE THE LIVES OF PEOPLE EXPERIENCING HOMELESSNESS THROUGH WHOLISTIC CARE. 5 0 0 0 0 0 2000000 0 0 30000 2030000 165000 0 451393 0 0 616476 1232869 797131 2628621 1831490 797131 TO SERVE PATIENTS EXPERIENCING HOMELESSNESS THROUGH AN INNOVATIVE "STREET MEDICINE" APPROACH BY CONTRACTING WITH MEDICARE AND MEDICAID HEALTH PLANS AS WELL AS HOSPITALS AND HEALTH SYSTEMS. 0 0 165000 165000 30000 HEALTHCARE IN ACTION'S PRIMARY ACTIVITY IS TO FACILITATE ACCESS TO HEALTHCARE SERVICES FOR HOMELESS INDIVIDUALS AND TO SUPPORT THE DELIVERY OF THE MEDICAL CARE BY OFFERING SPECIALIZED CARE MANAGEMENT, SOCIAL WORK, AND NAVIGATION SERVICES TAILORED TO THE UNIQUE AND UNMET NEEDS OF THIS POPULATION, INCLUDING HEALTHCARE, HOUSING, FOOD, AND OTHER SOCIAL SERVICES. 165000 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 1 0 0 1 0 0 0 0 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 5 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 CA X VIRGINIA HAVAI 5629895100 3800 KILROY AIRPORT WAY LONG BEACH CA 908065616 SACHIN JAIN DIRECTOR 0.50 39.50 X 0 2232612 1655096 ROMILLA BATRA DIRECTOR 0.50 39.50 X 0 1211524 423584 MICHAEL PLUMB DIRECTOR 0.50 39.50 X 0 504077 543307 KEVIN KAPPEL TREASURER AND COO 20.00 20.00 X X 0 192542 32955 MICHAEL HOCHMAN PRESIDENT & CEO 20.00 20.00 X X 0 192017 28734 KEVIN KROEKER SECRETARY 0.50 39.50 X 0 411087 257578 0 4743859 2941254 0 0 1 0 IRVINE TECHNOLOGY COMPANY 2850 RED HILL AVENUE SANTA ANA CA 92705 IT CONSULTING 304530 CROWELL & MORING LLC PO BOX 75509 BALTIMORE MD 21275 LEGAL 122982 2 2000000 2000000 MANAGEMENT FEE REVENUE 561000 30000 30000 30000 2030000 30000 0 0 165000 165000 384800 384800 15660 15660 23384 23384 27549 27549 129131 129131 60438 60438 3148 3148 16243 16243 398666 398666 49 49 4172 4172 734 734 978 978 OTHER 2917 2917 1232869 165000 1067869 0 0 2433623 0 79686 0 2484 118766 5938 0 112828 0 2628621 0 1221490 0 610000 0 1831490 X 797131 0 797131 0 2628621 797131 0 X 0 1 X 1 0 X 2000000 2000000 30000 30000 2030000 2030000 2000000 2000000 0 2000000 2000000 30000 2030000 2030000 X PART III, SHORT YEAR EXPLANATION: THE ORGANIZATIONS INITIAL YEAR WAS A SHORT YEAR BEGINNING ON JULY 20, 2021 AND ENDING ON DECEMBER 31, 2021. THE ORGANIZATION'S TAX YEAR END IS DECEMBER 31. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 118766 5938 112828 112828 X PART X, LINE 2: UNDER FASB ASC 740, INCOME TAXES, THE COMPANY IS REQUIRED TO RECOGNIZE A LIABILITY FOR EACH UNCERTAIN TAX POSITION AT THE AMOUNT ESTIMATED TO BE REQUIRED TO SETTLE THE ISSUES AS OF DECEMBER 31, 2021. THERE WERE NO LIABILITIES RECORDED FOR UNCERTAIN TAX POSITIONS. 1 HEALTHCARE IN ACTION MEDICAL GROUP 3800 KILROY AIRPORT WAY LONG BEACH CA 908065616 871942811 165000 0 TO SUPPORT OPERATIONS OF HEALTHCARE IN ACTION, MEDICAL GROUP. 1 PART I, LINE 2 HIA, INC MADE A RESTRICTED GRANT TO A RELATED ORGANIZATION SUBJECT TO A WRITTEN GRANT AGREEMENT. PER THE TERMS OF THE AGREEMENT, THE GRANTEE IS REQUIRED TO PROVIDE AN ANNUAL REPORT TO HIA DETAILING ALL EXPENDITURES MADE FROM THE GRANT. 0 1 0 0 0 0 0 0 0 SACHIN JAIN DIRECTOR 0 1021772 0 1190500 0 20340 0 1636862 0 18234 0 3887708 0 905500 ROMILLA BATRA DIRECTOR 0 483434 0 340998 0 387092 0 414183 0 9401 0 1635108 0 706558 MICHAEL PLUMB DIRECTOR 0 482645 0 0 0 21432 0 516706 0 26601 0 1047384 0 0 KEVIN KROEKER SECRETARY 0 239277 0 150000 0 21810 0 236641 0 20937 0 668665 0 0 KEVIN KAPPEL TREASURER AND COO 0 157300 0 26250 0 8992 0 12849 0 20106 0 225497 0 0 MICHAEL HOCHMAN PRESIDENT & CEO 0 182260 0 0 0 9757 0 12758 0 15976 0 220751 0 0 PART I, LINE 3 COMPENSATION FOR MICHAEL HOCHMAN (CHIEF EXECUTIVE OFFICER AND PRESIDENT- HEALTHCARE IN ACTION, INC) WAS ESTABLISHED BY A RELATED ORGANIZATION, SCAN GROUP, AND PAID BY SCAN HEALTH PLAN. THE RELATED ORGANIZATION USED THE FOLLOWING TO ESTABLISH THE PRESIDENT'S COMPENSATION: 1) COMPENSATION COMMITTEE; 2) INDEPENDENT COMPENSATION CONSULTANT; 3) COMPENSATION SURVEY OR STUDY; 4) APPROVAL BY THE SCAN GROUP BOARD OF DIRECTORS. PART I, LINE 4B SCAN GROUP AND SCAN HEALTH PLAN PROVIDE A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN TO OFFICERS AND SENIOR VICE PRESIDENTS VIA ITS SECTION 457(F) PLAN. FOR CONTRIBUTIONS MADE PRIOR TO DECEMBER 31, 2017, A PARTICIPANT BECOMES VESTED IN THE 457(F) PLAN UPON COMPLETION OF ONE OF THE CHOSEN VESTING OPTIONS: 1) FIVE YEARS OF SERVICE AND 62 YEARS OF AGE OR 2) 10 YEARS OF SERVICE. ON JANUARY 1, 2018, A NEW PLAN WAS ADOPTED, FOR CONTRIBUTIONS MADE ON OR AFTER THAT DATE, A PARTICIPANT BECOMES VESTED IN THE 457(F) PLAN FOLLOWING A 4 YEAR CLASS VESTING CYCLE. DEFERRED COMPENSATION FOR 2021, REPORTED ON SCHEDULE J, PART II, COLUMN B AND COLUMN C CONSISTS OF THE FOLLOWING: 1)457(F) EMPLOYER CONTRIBUTIONS ARE SUBJECT TO VESTING TERMS AND CONDITIONS AS NOTED THE PLAN DOCUMENTS. BASED ON THESE VESTING TERMS AND CONDITIONS, THERE IS SUBSTANTIAL RISK OF FORFEITURE. 2) 457(B) IS A DEFERRED COMPENSATION PLAN THAT THE EMPLOYER AND EMPLOYEE CONTRIBUTE TO, UP TO THE SCAN GROUP AND SCAN HEALTH PLAN'S DEFINED AND IRS ANNUAL LIMITS. 3) 403(B) QUALIFIED RETIREMENT PLAN CONTRIBUTIONS (EMPLOYER MATCH AND SAFE HARBOR) UP TO THE IRS ANNUAL LIMITS. 4) SCAN GROUP AND SCAN HEALTH PLAN PROVIDE AN INCENTIVE PLAN TO VICE PRESIDENTS AND ABOVE. THE INCENTIVE PLAN IS BASED ON ORGANIZATION AND INDIVIDUAL PERFORMANCE METRICS. PAYMENTS ARE MADE ON OR AROUND APRIL 1 OF THE SUBSEQUENT CALENDAR YEAR. 5) IN 2017, UPON RECOMMENDATION BY SCAN'S COMPENSATION CONSULTANT, SULLIVAN COTTER, THE COMPENSATION COMMITTEE APPROVED THE ELIMINATION OF THE DEFERRAL PORTION OF THE INCENTIVE COMPENSATION PLAN EFFECTIVE JANUARY 1, 2018. THE RECOMMENDATION BY SULLIVAN COTTER TO DISCONTINUE THE DEFERRAL COMPONENT OF THE PLAN WAS BASED ON BEST PRACTICES OF OTHER SIMILARLY SITUATED ORGANIZATIONS. THE ELIMINATION OF THE DEFERRAL COMPONENT RESULTED IN DISTRIBUTION TO ALL PARTICIPANTS OF ANY PREVIOUSLY UNPAID CONTRIBUTIONS IN 2017, EXCEPT IN CERTAIN INDIVIDUAL CIRCUMSTANCES THAT ARE GOVERNED BY THE LAW, IN WHICH CASE SCAN ADHERED TO THE GOVERNING PRACTICES. HEALTHCARE IN ACTION MEDICAL GROUP CONTROLLED ENTITY OF HIA INC. OFFICERS 165000 GRANT SUPPORT HIAMG DELIVERY OF MEDICAL SERVICES TO NEEDY INDIVIDUALS HEALTHCARE IN ACTION MEDICAL GROUP CONTROLLED ENTITY OF HIA INC. OFFICERS 30000 MANAGEMENT FEE 1 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS SCAN GROUP, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE ACCOUNTING FIRM OF DELOITTE TAX, LLP WORKING IN CONJUNCTION WITH SCAN'S FINANCE DEPARTMENT. SCAN HEALTH PLAN'S DIRECTOR OF ACCOUNTING HAS DIRECT RESPONSIBILITY FOR THIS EFFORT, SUBJECT TO SUPERVISION BY THE VICE PRESIDENT AND CONTROLLER OF SCAN HEALTH PLAN. 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 FOR AND/OR KNOWLEDGE REGARDING THE VARIOUS MATTERS DISCLOSED AND/OR DESCRIBED IN THE FORM. THE GENERAL COUNSEL, IN PARTICULAR, REVIEWS THE FORM 990 FOR ACCURACY AND COMPLETENESS. THE FORM 990 IS PROVIDED TO THE HEALTHCARE IN ACTION'S BOARD FOR REVIEW AFTER IT IS PREPARED, BUT PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING COMPENSATION FOR MICHAEL HOCHMAN (CHIEF EXECUTIVE OFFICER AND PRESIDENT -HEALTHCARE IN ACTION, INC), OFFICERS AND SENIOR VICE PRESIDENT OF HEALTHCARE IN ACTION, INC IS CONDUCTED BY THE HUMAN RESOURCES DEPARTMENT OF SCAN GROUP AND CHIEF EXECUTIVE OFFICER (CEO) OF SCAN HEALTH PLAN, WITH THE APPROVAL OF THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF SCAN GROUP. ALL OF THE VOTING MEMBERS OF THE COMPENSATION COMMITTEE ARE INDEPENDENT DIRECTORS. IN DETERMINING EACH EMPLOYEE'S COMPENSATION, THE HUMAN RESOURCES DEPARTMENT AND COMPENSATION COMMITTEE WORK WITH AND RELY UPON THE COUNSEL AND EXPERTISE OF AN OUTSIDE COMPENSATION CONSULTANT WITH WELL-ESTABLISHED EXPERIENCE AND EXPERTISE IN THE AREA OF NONPROFIT HEALTH CARE ORGANIZATIONS, EXECUTIVE COMPENSATION, AND COMPLIANCE WITH THE INTERMEDIATE SANCTIONS REQUIREMENTS APPLICABLE TO SUCH COMPENSATION. THE COMPENSATION CONSULTANT PROVIDES AN EXECUTIVE COMPENSATION REPORT TO THE HUMAN RESOURCES DEPARTMENT EACH YEAR WHICH FURNISHES THE BASIS FOR THE DETERMINATION OF EACH EMPLOYEE'S COMPENSATION PACKAGE DURING THE FOLLOWING YEAR. THE EXECUTIVE COMPENSATION REPORT IS BASED ON A REVIEW OF THE EXECUTIVE COMPENSATION PRACTICES OF A VARIETY OF ORGANIZATIONS CONSIDERED COMPARABLE TO SCAN HEALTH PLAN BASED ON VARIOUS METRICS. THE CHIEF EXECUTIVE OFFICER (CEO) MAKES A RECOMMENDATION TO THE COMPENSATION COMMITTEE WITH RESPECT TO EACH EMPLOYEE'S COMPENSATION PACKAGE IN LIGHT OF THE EXECUTIVE COMPENSATION REPORT. AT THE COMPENSATION COMMITTEE MEETING ADDRESSING SUCH MATTERS, QUESTIONS ARE ASKED OF, AND ANSWERED BY, THE COMPENSATION CONSULTANT, REGARDING THEIR REPORT AND OTHER MATTERS RELEVANT TO THE COMPENSATION PACKAGE; PURSUANT TO THEIR DELIBERATIONS, THE COMPENSATION COMMITTEE MAKES A DECISION REGARDING THE COMPENSATION PACKAGE FOR SUCH EMPLOYEES FOR THE FOLLOWING YEAR. THE MINUTES OF THE COMPENSATION COMMITTEE FOR THIS MEETING ARE PREPARED SUBSTANTIALLY CONTEMPORANEOUSLY AND SUBSTANTIVE SUCH DELIBERATION AND DECISIONS. THE OUTSIDE COMPENSATION CONSULTANT PROVIDING THE EXECUTIVE COMPENSATION REPORT AND GUIDANCE RELATED TO THE 2021 SALARY PACKAGE WAS SULLIVAN COTTER. FORM 990, PART VI, SECTION C, LINE 19 HEALTHCARE IN ACTION, INC'S GOVERNING DOCUMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. HEALTHCARE IN ACTION MAKES ITS FORM 990, WHICH CONTAINS FINANCIAL INFORMATION, AVAILABLE FOR PUBLIC INSPECTION. FORM 990, PART VI, SECTION B, LINES 12, 13 AND 14 IN 2021, HIA CURRENTLY OPERATES UNDER THE POLICIES THAT ARE MAINTAINED BY ITS SOLE MEMBER, SCAN GROUP. ONCE OPERATIONAL, HIA PLANS TO ADOPT THE FOLLOWING POLICIES OF SCAN GROUP: WHISTLEBLOWER POLICY, DOCUMENT RETENTION AND DESTRUCTION POLICY, AND CONFLICT OF INTEREST POLICY. SCAN GROUP 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 953826037 ADMIN SUPPORT CA 501(C)(3) 12B, II N/A 0 THE SCAN FOUNDATION 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 450552845 GRANT MAKING CA 501(C)(3) 12B, II SCAN GROUP 1 SCAN HEALTH NEVADA PLAN INC 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 854288083 MEDICARE ADVANTAGE NV 501(C)(4) SCAN GROUP 1 SCAN HEALTH PLAN 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 953858259 MEDICARE ADVANTAGE CA 501(C)(3) 10 SCAN GROUP 1 SCAN DESERT HEALTH PLAN INC 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 854275186 MEDICARE ADVANTAGE AZ 501(C)(4) SCAN GROUP 1 SCAN HEALTH PLAN TEXAS INC 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 872944493 MEDICARE ADVANTAGE TX 501(C)(4) SCAN GROUP 1 SCAN HEALTHCHECK ASSESSMENT CENTERS INC 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 462962358 HEALTHCARE CA N/A C 1 SCAN CALIFORNIA MANAGEMENT COMPANY 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 462951831 MANAGEMENT CA N/A C 1 ALIVE VENTURES INC 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 852381604 VENTURE STUDIO CA N/A C 1 HEALTHCARE IN ACTION MEDICAL GROUP 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 871942811 HEALTHCARE CA N/A C 1 WELCOME HEALTH INC 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 863730275 HEALTHCARE CA N/A C 1 WELCOME HEALTH MEDICAL GROUP 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 872705807 HEALTHCARE CA N/A C 1 PROSPER SERVICES LLC 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 872979343 HEALTHCARE CA N/A C 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 SCAN HEALTH PLAN C 2000000 BOOK VALUE SCAN GROUP P 1101326 BOOK VALUE SCAN HEALTH PLAN P 118766 BOOK VALUE HEALTHCARE IN ACTION MEDICAL GROUP B 165000 BOOK VALUE