2021-11-15T13:27:50-06:00 2020-12-31 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2020-01-01 461567681 ASPIRE HEALTH PLAN ASPI 8315744938 10 RAGSDALE DRIVE SUITE 101 MONTEREY CA 93940 MATT MORGAN VP, CFO 8315744938 2021-11-10 1 MATT MORGAN 999009999 RICHARD CROGHAN P00089862 4159561500 2021-11-03 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z MATT MORGAN 23625 HOLMAN HWY MONTEREY CA 93940 68333650 0 X WWW.ASPIREHEALTHPLAN.ORG X 2012 CA SOCIAL WELFARE THROUGH THE PROVISION OF HEALTH INSURANCE. 12 9 45 0 0 0 160000 0 47191733 68333500 150 150 0 0 47351883 68333650 0 0 0 0 5411249 5467495 0 0 0 53059370 69010579 58470619 74478074 -11118736 -6144424 12873908 11937116 57081656 62289288 -44207748 -50352172 SOCIAL WELFARE THROUGH THE PROVISION OF HEALTH INSURANCE. 0 0 66584698 68333500 INSURANCE CLAIMS EXPENDITURES FOR 3316 MEDICARE ADVANTAGE BENEFICIARIES. 3946697 ADMINISTRATIVE EXPENDITURES FOR 3316 MEDICARE ADVANTAGE BENEFICIARIES. 70531395 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 125 0 1 45 1 0 0 0 0 0 0 0 0 0 0 X 12 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X MATT MORGAN 8316254965 23625 HOLMAN HWY MONTEREY CA 93940 DAVID AWERBUCK DIRECTOR 1.00 0.00 X 0 0 0 PETE DELGADO DIRECTOR 1.00 0.00 X 0 0 0 EUGENE HILL DIRECTOR 1.00 0.00 X 0 0 0 SCOTT KELLY VP / COO / SECRETARY 55.00 0.00 X X 0 495294 72743 MICHAEL MCGLUE MD DIRECTOR 1.00 0.00 X 0 0 0 JOHN O'BRIEN CHAIR 1.00 0.00 X X 0 0 0 PETER OPPENHEIM MD DIRECTOR 1.00 0.00 X 0 0 0 STEVEN PACKER VICE CHAIR / CEO, MONTAGE 1.00 54.00 X X 0 1273470 102945 TONY PRUTHI MD DIRECTOR 1.00 0.00 X 0 0 0 ALLEN RADNER DIRECTOR 1.00 0.00 X 0 0 0 HARRY WARDWELL DIRECTOR 1.00 0.00 X 0 0 0 LAURA ZEHM PRESIDENT / CEO 8.00 47.00 X X 0 719570 256951 MATT MORGAN VICE PRESIDENT / CFO 8.00 47.00 X 0 624558 107515 ANTHONY SERRANO DIRECTOR OF COMPLIANCE 55.00 0.00 X 157206 0 16303 ALISON DUNTON DIRECTOR PRACTICE ENHANCEM 55.00 0.00 X 164000 0 26054 ELISABETH FAGAN DIRECTOR HEALTH PLAN OPS. 55.00 0.00 X 206049 0 17769 MELISSA HALL VP MEDICARE OPERATIONS 55.00 0.00 X 303987 0 26560 CYNTHIA O'BRIEN CHIEF SALES MANAGER 55.00 0.00 X 278106 0 28443 1109348 3112892 655283 10 0 1 0 PERFORMANCE HEALTH TECHNOLOGY 3993 FAIRVIEW INDUSTRIAL DRIVE SALEM OR 97302 BUSINESS PROCESS OUTSOURCING 2881387 GORMAN HEALTH GROUP 100 SE 3RD AVENUE 14TH FLOOR FORT LAUDERDALE FL 33394 HEALTH ASSESSMENT 172596 NOVU LLC 5401 GAMBLE DRIVE MINNEAPOLIS MN 55416 HEALTHCARE 161850 APPLIED GENERAL AGENCY 1040 N TUSTIN AVE ANAHEIM CA 92807 AGENT COMMISSIONS 158038 GREEN LEAF FINANCIAL 43385 BUSINESS PARK DRIVE TEMECULA CA 92590 AGENT COMMISSIONS 149196 10 CAPITATION REVENUE 900099 65528675 65528675 OTHER REVENUE 900099 2804825 2804825 68333500 150 150 68333650 68333500 0 150 4116411 3075104 1041307 104503 78547 25956 1013828 762021 251807 232753 174944 57809 186800 134809 51991 1063689 824560 239129 1092141 809219 282922 39180 30163 9017 464357 286966 177391 250100 194559 55541 4513 3332 1181 MEDICAL EXPENSES 59135568 59135568 DIRECT EXPENSES 6694556 4960325 1734231 DUES & SUBSCRIPTIONS 65577 48589 16988 OTHER TAXES 14098 12689 1409 74478074 70531395 3946679 0 572044 7702732 10389034 2212705 153078 61122 523868 511749 16632 12119 1743120 1948438 12873908 11937116 7146401 6360720 354193 267047 49581062 55661521 57081656 62289288 X -44207748 -50352172 -44207748 -50352172 12873908 11937116 -6144424 0 X 0 1 X 1 0 523868 511749 12119 12119 INTERCOMPANY RECEIVABLES 1948438 1948438 INTERCOMPANY PAYABLES 632045 RELATED PARTY PAYABLE 55029476 55661521 X PART X, LINE 2: ASPIRE HAS BEEN DETERMINED TO BE AN ORGANIZATION EXEMPT FROM INCOME TAXES BY THE INTERNAL REVENUE SERVICE PURSUANT TO SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE AND EFFECTIVE DECEMBER 23, 2015. ASPIRE HAS ALSO BEEN DETERMINED TO BE AN ORGANIZATION EXEMPT FROM INCOME TAXES BY THE CALIFORNIA FRANCHISE TAX BOARD PURSUANT TO SECTION 23701(F) OF THE CALIFORNIA REVENUE AND TAXATION CODE. ASPIRE ASSESSES UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE PROVISIONS OF THE FASB ASC TOPIC 740-10, INCOME TAXES. ASPIRE RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. ASPIRE RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. THERE WERE NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2020. 0 0 0 0 0 1 1 0 0 STEVEN PACKER VICE CHAIR / CEO, MONTAGE 0 898356 0 318750 0 56364 0 62656 0 40289 0 1376415 0 0 LAURA ZEHM PRESIDENT / CEO 0 537876 0 143520 0 38174 0 225300 0 31651 0 976521 0 0 MATT MORGAN VICE PRESIDENT / CFO 0 448062 0 150150 0 26346 0 65510 0 42005 0 732073 0 0 SCOTT KELLY VP / COO / SECRETARY 0 357987 0 88560 0 48747 0 55176 0 17567 0 568037 0 0 MELISSA HALL VP MEDICARE OPERATIONS 253967 0 40000 0 10020 0 8550 0 18010 0 330547 0 0 0 CYNTHIA O'BRIEN CHIEF SALES MANAGER 238241 0 37696 0 2169 0 8408 0 20035 0 306549 0 0 0 ELISABETH FAGAN DIRECTOR HEALTH PLAN OPS. 179236 0 25942 0 871 0 6208 0 11561 0 223818 0 0 0 ALISON DUNTON DIRECTOR PRACTICE ENHANCEM 133632 0 25440 0 4928 0 5068 0 20986 0 190054 0 0 0 ANTHONY SERRANO DIRECTOR OF COMPLIANCE 145773 0 6000 0 5433 0 4742 0 11561 0 173509 0 0 0 PART I, LINE 3 A RELATED ORGANIZATION HAS A COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES THAT REVIEWS AND APPROVES THE OFFICERS' COMPENSATION. A CONSULTING FIRM IS ENGAGED TO PROVIDE COMPARABLE DATA. PART I, LINE 6 PRESIDENT/CEO OF MONTAGE HEALTH HAS A DEFERRED COMPENSATION ARRANGEMENT BASED ON POSITIVE NET EARNINGS OF COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA. FORM 990, PART VI, SECTION A, LINE 6 ASPIRE HEALTH PLAN HAS ONE CLASS OF MEMBERS. THE MEMBERS ARE MONTAGE HEALTH AND SALINAS VALLEY MEMORIAL HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A MONTAGE HEALTH AND SALINAS VALLEY MEMORIAL HEALTH SYSTEM SHALL HAVE AND BE ENTITLED TO EXERCISE FULLY ALL RIGHTS AND PRIVILEGES OF MEMBERS OF NONPROFIT CORPORATIONS UNDER THE CALIFORNIA NONPROFIT CODE, AS AMENDED FROM TIME TO TIME, AND ALL OTHER APPLICABLE LAWS. FORM 990, PART VI, SECTION A, LINE 7B SEE DESCRIPTION FOR 7A ABOVE. FORM 990, PART VI, SECTION B, LINE 11B THE AUDIT COMMITTEE REVIEWS FORM 990 AND ELECTRONIC COPIES ARE SENT TO ALL BOARD OF TRUSTEES PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION USES SELF DISCLOSURE TO REGULARLY AND CONSISTENTLY MONITOR AND ENFORCE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. IT ALSO MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC ON ITS OWN WEBSITE. MONTAGE HEALTH PO BOX HH MONTEREY CA 93942 942789696 SUPPORT SERVICES CA 501(C)(3) LINE 10 N/A 0 MONTAGE MEDICAL GROUP PO BOX HH MONTEREY CA 93942 264826604 HEALTHCARE SERVICES CA 501(C)(3) LINE 3 MONTAGE HEALTH 0 COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA PO BOX HH MONTEREY CA 93942 940760193 HEALTHCARE SERVICES CA 501(C)(3) LINE 3 MONTAGE HEALTH 0 MONTAGE HEALTH FOUNDATION PO BOX HH MONTEREY CA 93942 812889645 SUPPORT SERVICES CA 501(C)(3) LINE 7 MONTAGE HEALTH 0 MOGO URGENT CARE PO BOX HH MONTEREY CA 93942 832329260 MEDICAL SERVICES CA 501(C)(3) LINE 3 MONTAGE HEALTH 0 CENTRAL COAST HEALTH CONNECT LLC 10 RAGSDALE DRIVE SUITE 102 MONTEREY CA 93940 611759835 HEALTH SERVICES CA N/A 0 0 COMMUNITY HEALTH INNOVATIONS LLC 23625 HOLMAN HIGHWAY MONTEREY CA 93940 454537290 HEALTH SERVICES CA N/A 0 0 SAN CARLOS & 7TH LLC 23625 HOLMAN HIGHWAY MONTEREY CA 93940 274672809 REAL ESTATE CA N/A 0 0 MONTEREY BAY ENDOSCOPY CENTER LLC 23625 HOLMAN HIGHWAY MONTEREY CA 93940 770324855 ENDOSCOPY CENTER CA N/A 0 0 CYPRESS MEDICAL NETWORK INC PO BOX HH MONTEREY CA 93942 770438780 MEDICAL SERVICES CA N/A C 0 CENTRAL COAST COMMUNITY MUTUAL INSURANCE COMPANY 40 MAIN STREET SUITE 200 BURLINGTON VT 05401 454016797 INSURANCE VT N/A C 0 COASTAL TPA INC PO BOX 80308 SALINAS CA 93912 770523382 MEDICAL CLAIMS PROCESSING CA N/A C 0 COASTAL HEALTHCARE ADMINISTRATORS PO BOX 80308 SALINAS CA 93912 770311413 MEDICAL CLAIMS PROCESSING CA ASPIRE HEALTH PLAN C -135631 136816 1.00000 1 BAY SERVICES INC PO BOX 80308 SALINAS CA 93912 942250761 SERVICES CA ASPIRE HEALTH PLAN C -800 982239 1.00000 1 0 0 0 0 1 1 0 0 0 1 1 0 0 1 1 1 1 1 1 COASTAL HEALTHCARE ADMINISTRATORS P 700000 ACTUAL/BOOK VALUE