2019-11-14T13:16:02-06:00 2018-12-31 861065772 Deloitte Tax LLP 200 Renaissance Center Suite 3900 Detroit MI 48243 990 2018-01-01 382242827 HEALTH ALLIANCE PLAN OF MICHIGAN HEAL 3136648130 2850 WEST GRAND BOULEVARD DETROIT MI 48202 Laurie Doran CFO 3136648559 2019-11-14 0 Alicia Janisch P00741382 3133963000 150.198.64.200 2019-11-14 14:08:16 ES P AB1DB372B0367D7F6A967A544E38B425EA745858 6A8D99C253AD97DAB86B5D513343FA457C071D3B 2018 2020-03-31 21:24:44Z Laurie Doran 2850 WEST GRAND BOULEVARD DETROIT MI 48202 1571873386 0 X www.hap.org X 1979 MI Provide access to quality health care coverage. 18 14 1305 104 0 16757 0 0 1828171270 1468005511 3663558 5202961 646092 756207 1832480920 1473964679 513718 574457 1641321598 1298593511 76922005 62063300 0 0 0 104707430 122191982 1823464751 1483423250 9016169 -9458571 678871294 614028005 335100035 259224615 343771259 354803390 X To improve the health status of the residents in all of the communities we serve. We accomplish this through innovative programs to provide health care coverage with an emphasis on preventative care as well as outreach programs to the communities aimed at enhancing and promoting healthier communities. 0 0 1453663121 574457 1468005511 Health Alliance Plan (HAP) is a nonprofit, regional health plan based in Detroit that provides health coverage to Individuals and companies. HAP is a subsidiary of the Henry Ford Health System, one of the nation's leading health care systems. A leader in personalized customer service, disease management and wellness programs, HAP partners with physicians, employers and community organizations to improve the health and well-being of the community.HAP offers seven distinct product portfolios: o Large and Small Group Fully Insured Commercial: - Small Business Solutions - HMO - EPO o Personal Alliance for Individuals (pre-65) and Families - HMO - PPO o Medicare Solutions for individuals and groups: - HAP Senior Plus (HMO) - HAP Senior Plus (HMO-POS) Participating Physicians and Ancillary Providers: HAP's robust provider networks include the leading Michigan doctors, hospitals and health systems: Beaumont, Detroit Medical Center, St. Joseph Mercy, St. John/Providence, Henry Ford Health System, Genesys, McLaren and the University of Michigan. HAP contracts with 95 Michigan hospitals to serve its HMO members. Statewide and national provider network solutions are available for other product lines through strategic partnerships with Physicians Care Network, CIGNA and NationCare for companies with multiple locations.HAP contracts with urgent care centers, pharmacies and ancillary providers to serve its membership. At the end of 2018, HAP's HMO membership enrollment was 180,860; HAP serviced 2,235,950 member months.Members worked with their chosen healthcare providers to maintain a healthy lifestyle or manage their chronic conditions. The following statistics reflect utilization for the HMO product: HAP HMO Commercial and Medicare members incurred 22,495 medical/surgical hospital admissions in 2018, this figure includes admissions for behavioral health-related issues. HAP and its providers encourage members to seek routine services and preventive health screenings to maintain their health and meet their personal health goals. The majority of these services are obtained in their physician offices. HAP spends a considerable amount of resources communicating with members and providing supportive health programs and resources to help them achieve sustainable healthy habits and manage chronic conditions. Examples of health and wellness programs and resources include:1) A team of Personal Service Coordinators are assigned to members during the first two years of membership to help them understand their HAP coverage and navigate the health care system.2) Online health assessment and digital coaching tools are available through iStrive for Better Health, HAP's digital wellness manager. IStrive is available toHAP members and their covered spouses in their hap.org account.3) Member events: HAP's member events help members eat healthfully, get moving, manage a chronic condition and more.4) Balanced Living member magazine and blog: The award-winning magazine and blog are filled with the latest health and wellness news, tips and answers to your questions by HAP experts, as well as helpful ideas to improve your well-being. 5) Weight management: HAP members enjoy discounts, access to nutritional counseling, doctor-supervised weight loss programs and much more. 6) Tobacco cessation: Ready to quit smoking for good? Our plans including smoking cessation benefits for HMO, POS and Medicare members.7) Global Emergency Services and Identify Theft Protection through Assist America: Urgent care and emergency services are covered worldwide. Our contract with Assist America provides a full range of emergency medical services to help with difficulties while traveling 100+ miles away from home, or abroad, and free identity theft protection.8) Restore programs help members take care of their daily health needs, manage their doctor's plan of care and improve their quality of life. There are three unique programs under Restore: Restore CareTrack helps members manage their chronic conditions; Restore Case Management helps members who need extensive help coordinating their care; and Restore Comfort and Palliative Care helps members managing terminal illnesses. 9) Behavioral health: Our dedicated team of professionals matches members with mental health and addiction resources and monitors their care throughout treatment.10) Medication Therapy Management Program: HAP pharmacists counsel seniors with chronic conditions and work with their physicians to make taking multiple medications safer and more effective and address the barriers to medication therapy adherence.11) Worksite Wellness programs bring free or low-cost preventive services and health education to the workplace tailored to the needs of each company. HAP offers: workshops on health and wellness topics, behavior change programs, health screenings, health fairs and wellness forums for employer groups. 12) HAP Member Discounts-members receive valuable money-saving discounts and extras on a variety of health-and-wellness related activities and venues. 13) Quarterly member wellness challenges are designed to engage members in friendly 'competition' to improve healthy behaviors like physical activity, nutrition, and stress management.14) Maternity Resources: Planning your pregnancy or expecting? We'll help you get the most from your health plan, and stay healthy during your journey, so you can focus on what's most important: your expanding family.Community Stewardship: HAP supports organizations and programs that promote the health and wellbeing of the communities we serve by sponsoring fundraising events, dinners, galas, golf outings, 5K runs/walks, and other types of events. Establishing and managing relationships with non-profit organizations is an important part of the work being done by community outreach leading to recognition, business leads, and community brand recognition with over 150 organizations that engage with HAP in this way each year. Organizations we support regularly through both financial support and employee volunteerism include the Detroit Urban League, Big Brothers Big Sisters, Orchards Children's Services, Angels of Hope, Humble Design, PlayWorks of Michigan, Forgotten Harvest, The Food Bank of Eastern Michigan and Turning Point.In 2018 HAP employees contributed over 2,500 volunteer hours to community service. Signature Community ProgramsNon-profit Board Service: HAP leaders and employees are encouraged to serve on the boards and committees of non-profit community organizations. Monetary support is offered to organizations where board positions are held on an annual basis, at the discretion of the sitting board member.Life Remodeled - 6-Day Project: HAP employee volunteers assist with this effort to clear blighted alleyways within a four-square mile geography surrounding the Durfee Innovation Society in Detroit. American Heart Association Heart and Stroke Walk: In 2018, HAP walkers and volunteers raised over $25,000 to support the AHA's efforts to combat heart disease and stroke, culminating in a 3-mile walk on the campus of Wayne State University.CrimFit Training Program: HAP members receive discounted registration for this 15-week guided training program designed for participants of all ages and fitness levels to help them prepare for the Crim 10 Mile, Half Crim 5 Mile, or 5K races held each August in Flint. The program consists of a weekly training session and monthly training calendars to guide participants along the way and includes race registration. Empowering Flint: This campaign is designed to inform and support mid-Michigan residents eligible for Medicaid. HAP partners with agencies that provide resources for low income residents and the homeless to improve quality of life and assist with the attainment of health insurance coverage. 1453663121 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 1 9345 0 1 1305 1 1 1 0 0 0 0 0 1 0 X 18 14 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X Laurie Doran 3136648130 2850 West Grand Boulevard Detroit MI 48202 Marvin W Beatty Director 1.00 0.00 X 0 0 0 Jeffrey A Chaffkin Director (Start 1/2018) 1.00 0.00 X 0 0 0 Shari L Burgess Director- Chair 2.00 4.00 X X 0 0 0 Joyce V Hayes Giles Director 1.00 0.00 X 0 0 0 Jamie C Hsu PhD Director 1.00 0.00 X 0 0 0 Sandra A Cavette MPH RDH Director 1.00 0.00 X 0 0 0 Marquerite S Rigby Director 1.00 0.00 X 0 0 0 Harvey Hollins III Director 1.00 0.00 X 0 0 0 Colleen M Ezzeddine PhD Director 1.00 0.00 X 0 0 0 Judith S Milosic Director 1.00 0.00 X 0 0 0 Susanne M Mitchell Director 1.00 0.00 X 0 0 0 Michelle B Schreiber MD Director 1.00 60.00 X 0 579684 57833 Jacalyn S Goforth Director 1.00 0.00 X 0 0 0 Teresa L Kline Director/President & CEO 53.00 12.00 X X 0 1294932 219202 Raymond C Lope Director 1.00 0.00 X 0 0 0 John Gorman Director(Start 1/2018) 1.00 0.00 X 0 0 0 Wright L Lassiter III Director 1.00 64.00 X 0 2987446 582465 Adnan R Munkarah MD Director 1.00 63.00 X 0 923523 55624 Annmarie Erickson Assistant Secretary (Thru 6/2018) 0.00 60.00 X 0 223356 20865 Richard E Swift Treasurer/CFO 55.00 5.00 X 0 0 0 Michelle Johnson Tidjani Esq Secretary 2.00 63.00 X 0 722678 134641 William R Barnes Assistant Secretary 55.00 5.00 X 262073 0 18167 Michael Genord MD Chief Medical Officer 55.00 5.00 X 664585 0 83571 Mary Ann Tournoux Chief Marketing Officer(Thru 4/2018) 55.00 5.00 X 387304 0 19540 Annette M Marcath VP & Chief Information Off 55.00 5.00 X 320945 0 45771 K Michael Treash SVP & COO 55.00 5.00 X 333113 0 40386 Margaret M Anderson SVP- Chief Sales & Marketing Officer 55.00 5.00 X 184537 0 4728 Balakrishna Pai MD VP- Quality & Disease Mgmt 60.00 0.00 X 403800 0 43093 John D Calabria MD Sr Medical Director 60.00 0.00 X 322701 0 24200 Charles Bloom VP- Utilization Mangement 60.00 0.00 X 389046 0 32321 Lori Rund VP- Prod Mgmt & Mrkt 60.00 0.00 X 289915 0 45560 Peter Watson MD VP-Care Mgmt & Outcomes 60.00 0.00 X 401963 11593 43596 Todd Hutchison Former Treasurer/CFO 55.00 5.00 X 312660 0 37473 Derick Adams Former VP Human Resources 20.00 40.00 X 267916 0 54446 Dianna L Ronan Former Treasurer 55.00 5.00 X 272255 0 46193 4812813 6743212 1609675 193 1 1 0 Accenture LLP PO Box 70629 Chicago IL 60673 Software support & consulting 7543553 Patricia N Harrison 24416 Crocker Blvd Clinton Twp MI 80111 Advertising 3723414 Sharnosa LLC 28400 NW Hwy Ste 400 Southfield MI 48034 Building Rent 2784392 Optuminsight Inc 28125 Network Place Chicago IL 60673 Software support & consulting 2515053 Medwise Consulting Partners Inc 10632 N Scottsdale Rd B489 Scottsdale AZ 85254 Executives Fees/Expenses 2189348 138 Health Care Premiums 524114 1463583028 1463583028 Hlth Ins Claims Assessmt 624110 4422483 4422483 1468005511 5808851 5808851 96754067 548750 97908707 0 -1154640 548750 -605890 -605890 756207 756207 756207 1473964679 1468005511 0 5959168 574457 574457 1298593511 1298593511 4057515 2654798 1402717 669813 350133 319680 34567394 30906191 3661203 11318724 10404368 914356 4391246 4036510 354736 7058608 6488396 570212 6489706 6489706 487258 487258 317615 317615 24826238 21577969 3248269 16600079 16552807 47272 6021458 5959194 62264 13814238 13809534 4704 5175377 4883174 292203 468077 405539 62538 163778 143868 19910 1603154 1603154 14092178 11053263 3038915 ACA TAX 24056165 24056165 Admin Alloc Fees 5824518 5824518 Eqp Rep / Maint 716534 633530 83004 Bank Fees 424432 424352 80 1111177 155362 955815 1483423250 1453663121 29760129 0 21504681 22458637 244900424 196124093 78279513 72856000 5130068 5220526 186896949 116431935 84830653 70465014 117219818 114823092 89458825 97036872 36459574 33714335 1087738 1329436 678871294 614028005 86772141 71257363 10318691 9948725 238009203 178018527 335100035 259224615 X 343771259 354803390 343771259 354803390 678871294 614028005 X -9458571 20490702 X X 0 1 X 1 0 851336 851336 8567873 5047614 3520259 7277939 5557360 1720579 31064211 19221290 11842921 139135590 86605671 52529919 70465014 HAP Preferred, Inc. 10438428 C Alliance Health & Life Insurance Co. 53747685 C Midwest 21408621 C ASR 11442138 C 97036872 Medical Claims 125885739 Capital Lease 272594 Pension 22839868 Note Payable 14166666 Capitation Payable 14853660 178018527 X Part X, Line 2: HAP is an entity described under Internal Revenue Code Section 501(c)(4) and as such is exempt from federal and state income taxes. Any income not substantially related to the organization's exempt purpose may be considered unrelated business income (UBI) under IRC Section 511 and, as such, subject to tax at normal corporate rates. HAP has concluded that there are no material uncertain tax positions as of December 31, 2018 and 2017. 0 National Kidney Foundation Of Michigan 1900 E Jefferson 222 Detroit MI 48207 381559941 501 (c)(3) 61209 Organizational/Community Support American Heart Association Inc 7272 Greenville Avenue Dallas TX 75231 135613797 501 (c)(3) 18239 Organizational/Community Support 100 Black Men One Ford Place Detroit MI 48202 383124115 501 (c)(3) 6000 Organizational/Community Support Crim Fitness Foundation Inc 452 S Saginaw Street Suite 1 Flint MI 48502 382595169 501 (c)(3) 85500 Organizational/Community Support Flint Cultural Center Corp 1221 E Kearsley St Flint MI 48503 386089075 501 (c)(3) 43524 Organizational/Community Support Economic Club of Detroit 211 West Fort St 710 Detroit MI 48226 380508823 501 (c)(3) 5000 Organizational/Community Support Whaley Childrens Center 1201 N Grand Traverse Flint MI 48503 381358235 501 (c)(3) 5000 Organizational/Community Support Playworks Education Energized 2990 W Grand Blvd Suite 231 Detroit MI 48202 943251867 501 (c)(3) 5000 Organizational/Community Support Michigan Fitness Foundation 32031 Townley Madison Heights MI 48071 383838904 501 (c)(3) 11000 Organizational/Community Support Big Brothers Big Sisters Of Flint and Genesee County 410 East Second Street flint MI 48503 382259541 501 (c)(3) 5850 Organizational/Community Support Chaldean Federation Of America 915 East Maple Road Birmingham MI 48009 382953203 501 (c)(3) 5000 Organizational/Community Support Dearborn Public Schools Education Foundation 18700 Audette Street Dearborn MI 48124 363857599 501 (c)(3) 5000 Organizational/Community Support Michigan Colleges Alliance 26555 Evergreen Road No 1210 Southfield MI 48076 381332962 501 (c)(3) 6000 Organizational/Community Support National Diversity Council 2401 Fountain View Dr Houston TX 77054 711037612 501 (c)(3) 5500 Organizational/Community Support YMCA of Metropolitan Detroit 1401 Broadway Suite 3A Detroit MI 48226 381358055 501 (c)(3) 10000 Organizational/Community Support Oakland University 202 Wilson Hall Rochester MI 48309 381714400 115 Government 6000 Organizational/Community Support Angels Of Hope A Family Cancer Foundation 14281 Bournemuth Shelby Township MI 48315 043795236 501 (c)(3) 10500 Organizational/Community Support Trinity Health- Michigan 20555 Victor Parkway Livonia MI 48152 382113393 501 (c)(3) 5000 Organizational/Community Support Michigan Black Chamber Of Commerce 1001 Woodward Ave Suite 910 Detroit MI 48226 320332340 501 (c)(3) 5000 Organizational/Community Support 18 1 Part I, Line 2: The community outreach department monitors grants paid to charitable and governmental entities. X 1 1 1 1 0 0 0 0 0 0 0 Michelle B Schreiber MD Director 0 372592 0 195099 0 11993 0 26534 0 31299 0 637517 0 0 Teresa L Kline Director/President & CEO 0 816335 0 478597 0 0 0 208634 0 10568 0 1514134 0 0 Wright L Lassiter III Director 0 1493805 0 1470239 0 23402 0 555257 0 27208 0 3569911 0 0 Adnan R Munkarah MD Director 0 734522 0 173026 0 15975 0 23784 0 31840 0 979147 0 0 Annmarie Erickson Assistant Secretary (Thru 6/2018) 0 108642 0 54215 0 60499 0 7204 0 13661 0 244221 0 0 Michelle Johnson Tidjani Esq Secretary 0 581097 0 139871 0 1710 0 110946 0 23695 0 857319 0 0 William R Barnes Assistant Secretary 177154 0 80000 0 4919 0 2895 0 15272 0 280240 0 0 0 Michael Genord MD Chief Medical Officer 464748 0 195099 0 4738 0 61723 0 21848 0 748156 0 0 0 Mary Ann Tournoux Chief Marketing Officer(Thru 4/2018) 127747 0 109150 0 150407 0 12195 0 7345 0 406844 0 0 0 Annette M Marcath VP & Chief Information Off 255851 0 64538 0 556 0 22715 0 23056 0 366716 0 0 0 K Michael Treash SVP & COO 295289 0 37824 0 0 0 12886 0 27500 0 373499 0 0 0 Margaret M Anderson SVP- Chief Sales & Marketing Officer 122707 0 40000 0 21830 0 1177 0 3551 0 189265 0 0 0 Balakrishna Pai MD VP- Quality & Disease Mgmt 293429 0 87371 0 23000 0 24508 0 18585 0 446893 0 0 0 John D Calabria MD Sr Medical Director 238717 0 58744 0 25240 0 19747 0 4453 0 346901 0 0 0 Charles Bloom VP- Utilization Mangement 282677 0 81659 0 24710 0 4279 0 28042 0 421367 0 0 0 Lori Rund VP- Prod Mgmt & Mrkt 237033 0 48479 0 4403 0 15891 0 29669 0 335475 0 0 0 Peter Watson MD VP-Care Mgmt & Outcomes 288349 11593 87752 0 25862 0 15965 523 27108 0 445036 12116 0 0 Todd Hutchison Former Treasurer/CFO 208382 0 72062 0 32216 0 10746 0 26727 0 350133 0 0 0 Derick Adams Former VP Human Resources 213157 0 46306 0 8453 0 19818 0 34628 0 322362 0 0 0 Dianna L Ronan Former Treasurer 216482 0 48775 0 6998 0 18734 0 27459 0 318448 0 0 0 Part I, Line 1a Part I - 1a: Tax indemnification and gross-up payments: Certain members of the organization's senior leadership received gross-up payments in regards to the supplemental executive retirement SERP 457 (f) plan. Part I, Line 3 The Chief Executive Officer for Health Alliance Plan is an employee of Henry Ford Health System, HAP's parent company. Henry Ford Health System has a Compensation Committee of the Board of Trustees consisting of all independent trustees. The committee meets throughout the year and is charged with the approval of the organization's overall compensation and benefit programs as well as the specific review and approval of the compensation of certain employees including the Chief Executive Officer of HAP. The committee directly engages an independent compensation advisor to assist with this process. The process includes evaluation of the individual's performance, utilization of compensation studies of similarly situated positions as well as comparisons to compensation as reported by other health care organizations. The reasonableness of compensation is evaluated based upon these and other factors. Part I, Lines 4a-b Part I- 4a Severance Payments: MaryAnn Tournoux $150,407 Annmarie Erickson $59,766 Todd E. Hutchison $31,179 Part I - 4b: Certain members of the organization's senior leadership team participate in a supplemental retirement program (SERP 457(f) Plan) that results in reportable taxable income as the benefits accrue, rather than as they are paid. It is an element of the plan design to absorb the advance tax impact of these plans for the participants. In such cases the related amounts are reported as taxable income to the individual and included in the determination of reasonable compensation. The employees that received this taxable benefit are also officers and or key employees of the company. 4b: HAP SERP 457(f) PLAN Participant Accrual Distribution Non-Vested Reportable W-2 Michael Genord, M.D. - - 46,931 - K. Michael Treash - - 18,232 - 4b: HFHS SERP 457(f) PLAN Participant Accrual Distribution Non-Vested Reportable W-2 Wright L. Lassiter III - - 531,473 - Teresa L. Kline - - 184,850 - Michelle Johnson Tidjani- - 87,849 - Adnan R. Munkarah, M.D. - - 154,094 - 4b: HFHS Nonqualified 457(b) PLAN Employee Employer Medicare Reportable 2018 Contr. 2018 Contr. Tax gross-Up W-2 Amounts Wright L. Lassiter III 18,500 - - 18,500 Michelle Schriber - 6,922 167 7,089 Adnan R. Munkarah, M.D. 11,072 - - 11,072 Derick W. Adams 1,300 - - 1,300 Medwise Partners See Below 2189348 See Below 0 Schedule L, Part IV - Business Transactions Involving Interested Persons: (A) Name Of Person: Medwise Consulting Partners Inc.(B) Relationship Between Interested Person and Organization: Owner/Officer(D) Description Of Transaction: Provided Management And Consulting Services Form 990, Part VI, Section A, line 3 Officers of the organization are employed by an unrelated third-party management company. The organization delegated control over management duties customarily performed by or under the direct supervision of officers or key employees to Medwise Consulting Partners Inc.,an unrelated third-party management company. Medwise Consulting Partners Inc.,assigned specific employees to serve in the capacity of Chief Financial Officer/Tresurer of the organization. The following officer, reported of from 990, Part VII, Section A, was employed by Medwise Consulting Partners Inc., and received the accompanying compensation from the management company during the calendar year. Richard E Swift, Chief Financial Officer/Treasurer: A. Regular Compensation- $458,900 B. Travel Reimbursement- $55,140 Form 990, Part VI, Section A, line 6 HAP is a nonprofit member corporation. The responsibility for the overall governance of the corporation is shared between the Member and the Board of Directors. HAP's sole member is Henry Ford Health System (HFHS), a 501(c)(3) corporation. The President and CEO of HFHS serves on the HAP Board of Directors. The President and CEO of HAP, who is also an employee of HFHS, serves on the HAP Board of Directors. Form 990, Part VI, Section A, line 7a The HAP Board of Directors is currently comprised of 13 Directors (previously was 18 at December 31, 2018). Two Directors are ex officio Directors: CEO of the Member (HFHS) and President of HAP (also an employee of the Member). All Directors are appointed by the Member's Board of Directors and include an HFHS Appointed Enrollee Representative (an individual who represents the health maintenance organization's membership of HAP) and a HFHS Appointed Physician Director (a member of the Henry Ford Medical Group, or credentialed within the HFHS). As indicated below, the Member may remove the HAP President and CEO and any of the Appointed Director, with or without cause. The Member approves recommendations of the HAP Board of Directors regarding the appointment/removal of the HAP President and CEO, amendments to the HAP articles of incorporation and bylaws, budget, mergers and acquisitions and potential Directors. Form 990, Part VI, Section A, line 7b The Member has the following reserved powers under the HAP Bylaws: 1) Appoint the Chairperson of the HAP Board of Directors. 2) Adopt an agreement of merger or consolidation, or approve the sale, lease or exchange of all or substantially all of HAP's property and assets. 3) Approve the transfer of assets to other organizations and individuals if such transfers in any fiscal year exceed five percent (5%) of the HAP's total assets. 4) Admit a person or entity as a new Member or terminate the membership of a Member. 5) Amend HAP's Articles of Incorporation or Bylaws upon approval by the HAP Board of Directors. 6) Appoint or remove the HAP President. 7) Dissolve or revoke the dissolution of HAP. 8) Approve HAP's capital and operating budgets. 9) Transfer assets of HAP, or to require HAP to transfer assets, to the Member or its assign(s) or designee(s) upon demand, whether within or without the state of domicile of the Corporation, to the extent necessary to accomplish the Member's goals and objectives. Form 990, Part VI, Section B, line 11b The process the organization uses to review Form 990 prior to filing with the IRS: - Review of the entire return with the organization's chief financial officer, chief operating officer and chief executive officer. - Review of all compensation matters and disclosures with the compensation committee of the organization's board of trustees. - Review of the return with the HAP finance committee of the board of trustees. - Provide a copy of the return to the board of trustees. Form 990, Part VI, Section B, line 12c The process for regularly and consistently monitoring and enforcing compliance with the conflict of interest policy for all directors and officers: HAP has a robust compliance program. The program requires all directors and officers of HAP to complete a conflict of interest document. The documents are reviewed and maintained by the Compliance Officer. In addition, HAP is required to submit Board disclosure statements to the Michigan Office of Finance and Insurance Regulations. Thus, on an annual basis, all Directors, Officers, and key employees, and others subject to IRS Form 990 reporting are requested to complete the Conflict of Interest Questionnaire. In addition, they are provided a copy of the policy. The Compliance Officer tracks receipt of the Conflict of Interest Questionnaire and follows-up on any identified conflicts. All conflicts are reported to the HAP Board of Directors' Audit Committee, and the President and CEO for review and resolution. All Directors and Officers are required, under the policy, to report to the Compliance Officer any conflicts that may arise during the year. Violations of the Conflicts of Interest Policy - The board determines if the member has in fact failed to disclose an actual or possible conflict of interest and it shall take appropriate disciplinary and corrective action. Form 990, Part VI, Section B, line 15 Part VI Section B, Question 15a & b The Organization is an affiliate of Henry Ford Health System (HFHS) who has the responsibility to oversee the compensation practice of the Organization. HFHS has a compensation committee of the board of trustees consisting of all external trustees. They meet periodically throughout the year. They are charged with approval of the Organization's overall compensation and benefit programs as well as the specific review and approval of the compensation of certain employees including the CFO, all officers and key employees of the Organization. They directly engage an independent compensation advisor to assist with this process. The process includes evaluation of the individual's performance, utilization of compensation studies of similarly situated positions, as well as comparisons to compensation as reported by other health care organizations. The reasonableness of compensation is evaluated based upon these and other factors. The committee also reviews the compensation disclosure to be made on Form 990 in advance of filing. Form 990, Part VI, Section C, line 19 The process of making governing documents, conflict of interest policy and financial statements available to the public: HAP is committed to transparency. Therefore, HAP consistently and regularly discloses most information to our providers, consumers, and employer groups. HAP's governing documents and conflict of interest policy are available on the internet. HAP Bylaws, Articles of Incorporation, and financial statements are submitted to the Michigan Office of Financial and Insurance Regulations. They are available to the public through a Freedom of Information Act request to this agency. Also, financial statements, conflict of interest policy and governing documents are available upon request for the same period of disclosure as set forth in IRC Section 6104(d). In addition, HAP will provide its Form 990 to anyone who requests to view it or to receive a copy of the Form 990. The Form 990 is also available for viewing on the following website: www.guidestar.org Form 990, Part XI, line 9: HAP Pension Adjustment 8,659,137. Change in value of subsidiaries 14,329,332. Proceeds From Dissolution of HealthPlus Trust 6,531,626. Acquisition Non-Controlling Interest (ASR Adj) -9,029,984. Misc Adjustment 591. FORM 990, PART XII - LINE 2C Health Alliance Plan of Michigan is included in the consolidated financial statements of Henry Ford Health System. The governing body of HFHS has delegated the oversight of the financial statements, including the choice of independent auditors, to its audit committee. PART IV, LINE 12 The Organization is an element of the external audit report obtained for the consolidated operations of Henry Ford Health System. FORM 990, PART VII Average hours per week devoted to related organizations: Many executive employees of Henry Ford Health System and affiliates provide services to multiple affiliated entities. Henry Ford Health System and affiliates use estimates for reporting average hours per week in all sections of Form 990. Generally 60 hours are reported for the hours associated for the organization that the individual has principal responsibility for. Hours associated with other hospitals or affiliates are reported at between 1 to 5 hours per week. Henry Ford Health System One Ford Place Detroit MI 48202 381357020 Healthcare Service Provider MI 501(c)(3) Line 3 N/A 0 Henry Ford Macomb Hospital Corporation One Ford Place Detroit MI 48202 382947657 Healthcare Service Provider MI 501(c)(3) Line 3 Henry Ford Health System 1 Henry Ford Health System Foundation One Ford Place Detroit MI 48202 237383042 Supporting Organization MI 501(c)(3) Line 12a, I Henry Ford Health System 1 Henry Ford Wyandotte Hospital 2333 Biddle Ave Wyandotte MI 48192 382791823 Healthcare Service Provider MI 501(c)(3) Line 3 Henry Ford Health System 1 HFHS Self Funded Liability One Ford Place Detroit MI 48202 386553031 Malpractice Insurance MI 501(c)(4) N/A Henry Ford Health System 1 Henry Ford Allegiance Health Group 205 N East Avenue Jackson MI 49201 382756428 Healthcare Service Provider MI 501(c)(3) Line 12b, II Henry Ford Health System 1 HFII Corporation One Ford Place Detroit MI 48202 900840304 Scientific Research MI 501(c)(3) Line 7 Henry Ford Health System 1 Henry Ford Government Affairs Services One Ford Place Detroit MI 48202 464064067 Advocacy Svs for HFHS & Affil's MI 501(c)(4) N/A Henry Ford Health System 1 Allegiance Health Foundation 205 N East Avenue Jackson MI 49201 383607833 Supporting Organization MI 501(c)(3) Line 12b, II Henry Ford Allegiance Health Group 1 Hospice of Jackson dba Allegiance Hospice 205 N East Avenue Jackson MI 49201 382336367 Hospice Care MI 501(c)(3) Line 7 Healthlink 1 The Hospice of Jackson Endowment Fund One Jackson Square Jackson MI 49201 383422146 Supporting Organization MI 501(c)(3) Line 12b, II Allegiance Hospice 1 Healthlink 205 N East Avenue Jackson MI 49201 382756425 Home Health Care MI 501(c)(3) Line 12a, I Henry Ford Allegiance Health Group 1 Henry Ford Allegiance Specialty Hospital 110 North Elm Avenue Jackson MI 49201 381218485 Long Term Acute Hospital MI 501(c)(3) Line 3 Henry Ford Allegiance Health Group 1 WA Foote Memorial Hospital 205 N East Avenue Jackson MI 49201 382027689 Healthcare Service Provider MI 501(c)(3) Line 3 Henry Ford Allegiance Health Group 1 The Clarence S Livingood Lectureship And Education Fund 3031 West Grand Boulevard No 800 Detroit MI 48202 382682321 Supporting Organization MI 501(c)(3) Line 12b, II Henry Ford Health System 1 Northwest Detroit Dialysis 30100 Telegraph Bingham Farms MI 48025 383232668 Operate Dialysis Clinic MI Henry Ford Health System Related 0 0 Macomb Regional Dialysis Centers 16151 Nineteen Mile Rd Clinton Township MI 48038 260423581 Operate Dialysis Clinic MI Henry Ford Health System Related 0 0 Foote Health Care Associates 1100 E Michigan Avenue Jackson MI 49201 383017711 Lessor of Medical Condominiums MI Henry Ford Allegiance Health Group Related 0 0 Alliance Health and Life Insurance Company 2850 West Grand Boulevard Detroit MI 48202 383291563 Health Insurance MI Health Alliance Plan C 349324392 133961538 1.00000 1 HAP Preferred Inc 2850 West Grand Boulevard Detroit MI 48202 382513504 Provider Network Leasing MI Health Alliance Plan C 11390705 11374394 1.00000 1 Sha Realty Inc One Ford Place Detroit MI 48202 381378121 Recreational Service - Golfing MI Henry Ford Health System C 1 Fairlane Health Services 30100 Telegraph Bingham Farms MI 48025 382565235 Healthcare Management MI Henry Ford Health System C 1 Onika Insurance Ltd First Carribean House Grand Cayman CJ Captive Insurance CJ Henry Ford Health System C 1 HAP Midwest Health Plan Inc 2800 West Grand Boulevard Dearborn MI 48126 383123777 Health Insurance MI Health Alliance Plan C 116495579 55701376 1.00000 1 Administration Systems Research Corporation International 2850 West Grand Boulevard Detroit MI 48202 382651185 Third Party Administrator MI Health Alliance Plan C 41456239 23409326 1.00000 1 Henry Ford Physician Network One Ford Place Detroit MI 48202 320306774 Physician Network MI Henry Ford Health System C 1 Henry Ford Allegiance Pharmacy 205 N East Avenue jackson MI 49201 383370242 Pharmacy MI Henry Ford Allegiance Health Group C 1 0 0 1 0 1 0 0 0 0 1 0 1 1 1 0 1 1 1 1 WA Foote Memorial Hospital M 2715820 Fair market value Henry Ford Wyandotte Hospital M 23756446 Fair market value Henry Ford Macomb Hospital Corporation M 34721206 Fair market value Alliance Health & Life Insurance Company M 1241633 Fair market value Northwest Detroit Dialysis Center M 2290531 Fair market value Macomb Regional Dialysis M 327562 Fair market value Alliance Health & Life Insurance Company Q 65279768 Fair market value HAP PreferredInc Q 8235206 Fair market value HAP Midwest Health Plan Q 20785779 Fair market value Henry Ford Physician Network S 503248 Fair market value SCHEDULE R, PART V, LINE 1D & 1E: The organization, as a Designated Affiliate, is a member of the Henry Ford Health System Credit Group. Members of the Credit Group are jointly and severally liable for outstanding obligations issued under the 2016 HFHS Bond Master Indenture. SCHEDULE R, PART V, LINE 2, COL. C: All transactions involved cash transfers at the time of services rendered or received. Therefore, the cash value at the time of the transactions is considered the fair market value.