2017-11-15T12:02:08-06:00 2016-12-31 910189318 Moss Adams LLP 101 Second Street Suite 900 San Francisco CA 94105 990 2016-01-01 461567681 Aspire Health Plan ASPI 8315744938 10 Ragsdale Drive Suite 101 Monterey CA 93940 Matthew Morgan VP, CFO 8315744938 2017-11-13 1 Richard Croghan P00089862 4159561500 2017-11-13 12.129.7.100 2017-11-13 16:01:53 PS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 77D8D66CE2F074441361C0A43DEB59CA8CC3760F 2016 2017-02-10 21:41:12Z Matt Morgan 10 Ragsdale Drive Suite 101 Monterey CA 93940 18413588 0 X www.aspirehealthplan.org X 2012 CA Social welfare through the provision of health insurance. 7 5 22 0 0 0 0 0 0 14793350 0 1175165 0 2445073 0 18413588 0 0 0 0 0 3524630 0 0 0 0 19580232 0 23104862 0 -4691274 3729395 7411587 5367813 23008248 -1638418 -15596661 Social welfare through the provision of health insurance. 0 0 20979242 14793350 Insurance claims expenditures for 818 Medicare Advantage beneficiaries. ADMINISTRATIVE EXPENDITURES FOR 818 MEDICARE ADVANTAGE BENEFICIARIES. 20979242 0 0 0 0 0 0 0 0 0 1 0 0 0 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 0 0 1 74 0 1 22 1 0 0 0 0 0 0 0 0 X 7 5 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X Matt Morgan 8316254965 23845 Holman Highway Suite 105 Monterey CA 93940 Scott Kelly VP/COO/Secretary 55.00 X X 0 462429 87509 Steven Packer Vice Chair 1.00 54.00 X X 0 1005549 315494 John O'Brien Chair 1.00 X X 0 0 0 Eugene Hill Director 1.00 X 0 0 0 Sameer Bakhda Director 1.00 X 0 0 0 David Awerbuck Director 1.00 X 0 0 0 Rebecca Abundis Director 1.00 X 0 0 0 Laura Zehm President/CEO 8.00 47.00 X 0 672639 108362 Matt Morgan Vice President/CFO 8.00 42.00 X 0 296500 50970 Alan Sokolow MD Vice President/CMO 55.00 X 0 326818 42717 Alison Dunton Director, PEA 40.00 X 115051 0 0 Melissa Hall Director, Compliance 40.00 X 181693 0 0 Diana Hatcher Bus Intelligence Program Manager 40.00 X 156992 0 0 Sharon Malensek Director, Sales 40.00 X 142813 0 0 596549 2763935 605052 4 0 1 0 Performance Health Technology 3993 Fairview Industrial Drive Salem OR 97302 Business Process Outsourcing 518952 Change Healthcare Solutions LLC PO Box 572490 Murray UT 84157 HEalthcare Technology 270424 National Pharmaceutical PO Box 407 Boys Town NE 68010 Pharmaceuticals 167638 CenseoHealth 4055 Valley View Lane Dallas TX 75244 Health Assessment 154980 J&S Therapeutic Designs 3246 Healtherglow Street Thousand Oaks CA 91360 Clinical Pharmacist 130910 6 Capitation Revenue 900099 13692754 13692754 Other Revenue 900099 1100596 1100596 14793350 1175165 1175165 Gain on Debt Forgiveness 900099 2445073 2445073 2445073 18413588 14793350 0 3620238 X 2669172 2172449 496723 67628 54712 12916 638728 513438 125290 149102 121299 27803 682216 547017 135199 32595 29252 3343 3991206 2941523 1049683 142294 107129 35165 213449 153382 60067 230911 182510 48401 54429 40699 13730 Medical Expenses 13687712 13687712 Other Taxes 109565 85530 24035 Dues & Subscriptions 28018 21661 6357 407837 320929 86908 23104862 20979242 2125620 0 2161345 1242147 822252 5441898 149917 210899 516038 101145 53281 414893 542600 101750 3729395 7411587 1164665 2369985 6576 96593 4134273 0 62299 20541670 5367813 23008248 X -1638418 -15596661 -1638418 -15596661 3729395 7411587 X -4691274 -9266969 X 0 1 X 1 0 516038 101145 414893 414893 Intercompany payables 572594 Related Party Payable 19969076 20541670 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, 2016. 0 0 0 0 0 0 0 0 0 Scott Kelly VP/COO/Secretary 0 344877 0 57970 0 59582 0 61966 0 25543 0 549938 0 0 Steven Packer Vice Chair 0 696682 0 270000 0 38867 0 285621 0 29873 0 1321043 0 0 Laura Zehm President/CEO 0 492646 0 159120 0 20873 0 82819 0 25543 0 781001 0 0 Matt Morgan Vice President/CFO 0 239466 0 41108 0 15926 0 14702 0 36268 0 347470 0 0 Alan Sokolow MD Vice President/CMO 0 304318 0 22500 0 0 0 26250 0 16467 0 369535 0 0 Melissa Hall Director, Compliance 158761 0 22932 0 0 0 0 0 0 0 181693 0 0 0 Diana Hatcher Bus Intelligence Program Manager 156992 0 0 0 0 0 0 0 0 0 156992 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. Form 990, Part VI, Section A, line 4 In December 2016, Salinas Valley Memorial Health System acquired 49% of Aspire Health Plan. The bylaws were amended to add Salinas Valley Memorial Health System as a member. 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. Form 990, Part IX, line 11g Other Professional Fees: Program service expenses 2,941,523. Management and general expenses 1,049,683. Fundraising expenses 0. Total expenses 3,991,206. Form 990, Part XI, line 9: Equity Transfer -9,266,969. COMMUNITY HOSPITAL PROPERTIES PO BOX HH MONTEREY CA 93942 942795922 SUPPORT SERVICES CA 501(c)(3) Line 12a, I Montage Health 0 COMMUNITY HOSPITAL ENDOWMENTS PO BOX HH MONTEREY CA 93942 942795423 SUPPORT SERVICES CA 501(c)(3) Line 12a, I Montage Health 0 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 23625 Holman Hwy MONTEREY CA 93942 812889645 SuppoRT SERVICES CA 501(c)(3) Line 7 Montage Health 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 188133 549404 1.00000 0 Bay Services Inc PO Box 80308 Salinas CA 93912 942250761 Services CA Aspire Health Plan C 123025 569371 1.00000 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0