2016-11-04T17:30:34-05:00 2015-12-31 BDO USA LLP 600 ANTON BLVD STE 500 COSTA MESA CA 92626 990 2015-01-01 953858259 SCAN HEALTH PLAN % VIRGINIA HAVAI SCAN 5629895100 3800 KILROY AIRPORT WAY Suite 100 LONG BEACH CA 90806 VINOD MOHAN CFO 5629895100 2016-11-02 true WALTER H HICK JR P01070437 7149573200 2015 2017-02-10 21:41:12Z CHRISTOPHER WING 3800 Kilroy Way ste 100 Long Beach CA 90806 2509836465 false X WWW.SCANHEALTHPLAN.COM X 1983 CA SCANS MISSION IS TO KEEP SENIORS HEALTHY AND INDEPENDENT. 11 10 1027 2654 0 3653657 3742566 2013469295 2165129374 16206782 22668603 0 7786 2033329734 2191548329 358579 539636 0 0 75205875 84016498 0 0 0 2014607401 2058409266 2090171855 2142965400 -56842121 48582929 575654478 569821364 173290210 217647454 402364268 352173910 X SCANS MISSION IS TO KEEP SENIORS HEALTHY AND INDEPENDENT. false false 1931109126 47508 2165129374 SEE ATTACHED ON SCHEDULE O 12244668 492128 SEE ATTACHED ON SCHEDULE O 400397 SEE ATTACHED ON SCHEDULE O 1943754191 true true false true false false false false false false true true false false true true true true false false false false false false false false false true false true false false false false false false false false false false false false false true true true true false true 4836 0 true 1027 true false false false false false false false false false false X 11 10 false false false false true true false true true false false true true true true true true true true false CA X VIRGINIA HAVAI 5629895100 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 Ryan Trimble Director 0.6 7.7 X 137695 0 0 Colleen Cain Director 0.5 7.8 X 125000 0 0 Leobardo Estrada Director 0.5 4.5 X 78000 0 0 Thomas Higgins Director 0.4 6.9 X 105000 0 0 Andrew Allocco Director 0.5 4.1 X 82000 0 0 Kim Hunter Director 0.5 4.1 X 70000 0 0 Patrick Seaver Director 0.5 6.9 X 115500 0 0 Michael Noel Director 0.5 7.0 X 107500 0 0 Francesca Ruiz De Luzuriaga Director 0.5 4.5 X 82000 0 0 Christopher Wing Chief Executive Officer 29.0 11.0 X X 1061356 0 1181020 Jennie Chin-Hansen Director 0.3 5.5 X 60959 15625 0 William Roth President 30.0 10.0 X 657812 0 614956 Nancy Monk Chief Admin Officer 32.0 8.0 X 0 461172 395293 Catherine Batteer SVP & GM All Scan Markets 30.0 10.0 X 467445 0 349869 Vinod Mohan chief financial officer 30.0 10.0 X 559982 0 458685 Janet Kornblatt Secretary 30.0 10.0 X 0 407978 365095 Sherry Stanislaw SVP & GM So Cal Market 36.0 4.0 X 450897 0 256279 Peter Begans SVP Public & Government Affair 20.0 20.0 X 0 609811 276236 Eve Gelb SVP Healthcare Services 32.0 8.0 X 347468 0 240396 Josh Goode Chief Technology Executive 32.0 8.0 X 0 346184 245787 David Milligan SVP Sales 36.0 4.0 X 350042 0 241335 Riaz Ali Chief Marketing Executive 20.0 20.0 X 318724 0 225186 Romilla Batra Chief Medical Executive 32.0 8.0 X 398961 0 200236 Sharonjit Jhawar VP Pharmacy 32.0 8.0 X 388355 0 186832 Dan Osterweil Medical Director 32.0 8.0 X 385846 0 162010 Kwan-Moon Leung SVP Healthcare Informatics 36.0 4.0 X 0 411899 247056 Christian Zorn Outgoing VP Internal Audit 32.0 8.0 X 0 467114 33232 Timothy Schwab Former Chief Med & Vision 0.0 0.0 X 250552 0 0 6601094 2719783 5679503 127 true true false EXPRESS SCRIPTS 21653 NETWORK PLACE CHICAGO IL 60673 MEDICAL SERVICES 369116579 HERITAGE PROVIDER NETWORK 8510 BALBOA BLVD 285 NORTHRIDGE CA 91325 MEDICAL SERVICES 222734077 SCRIPPS HEALTH PLAN SERVICES 10666 N TORREY PINES RD SAN DIEGO CA 92037 MEDICAL SERVICES 93821495 DAVITA HEALTHCARE PARTNERS PLAN 19191 S VERMONT SUITE 200 TORRANCE CA 90502 MEDICAL SERVICES 281629340 PRIMECARE MEDICAL NETWORK INC 3990 CONCOURSE 4TH FLOOR ONTARIO CA 91764 MEDICAL SERVICES 137991135 444 3703686 38880 3742566 MEDICARE PREMIUMS 900099 2116317116 2116317116 MEDI-CAL PREMIUMS 900099 48812258 48812258 2165129374 8616023 8616023 0 0 0 0 0 332340716 0 318186458 101678 14154258 -101678 14052580 14052580 0 0 0 OTHER REVENUE 900099 7786 7786 7786 2191548329 2165129374 22676389 X 539636 539636 0 0 0 7237542 7237542 0 62295112 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3742566 18567182 1634965549 1682067393 1862239431 2013469295 2165129374 9357871042 0 0 0 1638795654 1685772962 1865874716 2017122952 2168871940 9376438224 0 0 0 9376438224 2795274 14221474 11114175 9788407 8616023 46535353 0 2795274 14221474 11114175 9788407 8616023 46535353 0 0 1641590928 1699994436 1876988891 2026911359 2177487963 9422973577 0.99506 0.99268 0.00494 0.00732 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X X true false false false true 5559 false false true 649474 false true 33922 688955 false Form 990, Schedule C, Part II-B: Lobbying expenses represent SCAN's advocacy on behalf of the seniors we serve. They include employee salaries, outside counsel fees, consulting fees, and trade association dues attributable to direct federal lobbying. SCAN works to increase awareness of the unique needs of the elderly and to enhance the programs that will help them to maintain their independence and remain in their homes and communities for as long as possible. 24566174 17478005 7088169 11080060 9074470 2005590 22014236 16709753 5304483 14398242 US GOVERNMENT & AGENCY 0 OBLIGATIONS 40284831 F CORPORATE BONDS 49582459 F ASSET-BACKED SECURITIES 42640771 F MORTGAGE-BACKED SECURITIES 82027114 F COMMINGLED FUNDS 10103187 F 224638362 0 DEFERRED COMPENSATION LIABILIT 4060189 4060189 X 2166557905 -23773287 -23773287 2190331192 1217137 1217137 2191548329 2141748264 2141748264 1217136 1217136 2142965400 PART X, FIN 48 FOOTNOTE TO FINANCIAL STATEMENTS: 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, 2015 and 2014, there were no liabilities recorded for uncertain tax positions. true Project Angel Food 922 Vine St Los Angeles CA 90038 954115863 501(c)(3) 15000 Grant to provide medically tailored meals to medically compromised seniors; and sponsorship of Holiday Pie Drive Family Service Association 21250 Box Springs Road Moreno Valley CA 92557 951803694 501(c)(3) 15000 Provide gap funding to sustain ongoing provision of meals to seniors in Riverside County. Episcopal Senior Communities Foundation 2185 N California Blvd Ste 575 Walnut Creek CA 94596 460502111 501(c)(3) 15000 Funding will provide one-time financial support for low-income older adults faced with unexpected expenses Life Skills Training and Educational 4041 Bridge St Fair Oaks CA 95628 330720982 501(c)(3) 15000 Funding will provide EAF for older adults served throughout 77 affordable communities Jewish Federation & Family Services Orange County 1 Federation Way Ste 210 Irvine CA 92603 952407026 501(c)(3) 10000 Funding will support seniors in need of emergency assistence through JFFS programs AgeWell Senior Services 24300 El Toro Rd Ste A-2000 Laguna Woods CA 92637 931163563 501(c)(3) 10000 Funding would provide a minimum of 40 seniors EAF through purchase of services and/or equipment Institute on Aging 3575 Geary Blvd San Francisco CA 94118 942978977 501(c)(3) 20000 Funds will support Friendship Line - Senior Suicide Hotline through funding shortfall - serves all of California and National needs Jewish Family Service of San Diego 8804 Balboa Ave San Diego CA 92123 951644024 501(c)(3) 10000 Funds will provide dietary specific home-delivered meals and wellness checks for low-income, homebound seniors Second Harvest Food Bank of Orange County 8014 Marine Way Irvine CA 92618 320362611 501(c)(3) 10000 Funds will support Brown Bag Program for seniors and promote Senior Community Gardens for Nutrition Program Smiles for Seniors 34910 Avenue C Yucaipa CA 92399 260373602 501(c)(3) 15000 Provides Emergency Assistance to low-income seniors throughout the Inland Empire Marin Senior Coordinating Council 930 Tamalpais Ave San Rafael CA 94901 941422463 501(c)(3) 15000 Support 10,000 meal increase through Meals on Wheels, Brown Bag Pantry, Jackson Caf & Home Delivered Groceries Project Access 3900 Birch St Ste 113 Newport Beach CA 92660 330834635 501(c)(3) 15000 Will assist at least 150 seniors maintain independence through EAF Area Agency on Aging Serving Napa and Solano 400 Contra Costa St Vallejo CA 94590 942742309 501(c)(3) 15000 Establish EAF to meet the needs of assessed clients that are beyond the scope of county programs Human Services Association 6800 Florence Ave Bell Gardens CA 90201 951816054 501(c)(3) 27500 Emergency Assistance grant; Nutrition Assistance grant; sponsorship of fundraising gala St Barnabas Senior Services 675 S Carondelet Los Angeles CA 90057 951641435 501(c)(3) 15000 Funds will be used to address the increased demand in the Nutrition Program Community SeniorServ 1200 N Knollwood Cir Anaheim CA 92801 952771715 501(c)(3) 15000 Funds will be used towards eliminating the 100+ waiting list for HDM Watts Labor Community Action Committee 10950 S Central Ave Los Angeles CA 90059 952412869 501(c)(3) 15000 Funds will provide meals to low-income, frail, isolated seniors who are living below the federal poverty level. Community Action Partnership of Orange County 11870 Monarch St Garden Grove CA 92841 952452787 501(c)(3) 10000 Farm 2 Seniors program- obtain and distribute 100,000 lbs of fresh produce that will feed 20,000 seniors. 18 0 Form 990 Schedule I - PART I, LINE 2 All grantees submit a quarterly report documenting metrics and performance year- to- date throughout the duration of the funding. The Manager, Community Outreach and Giving, tracks and reviews the reports to ensure compliance. The Manager addresses any issues with the grantee to identify causes and any remediation required. Issues with compliance are raised to the Vice President, Independence at Home who will assist with remediation or elevate to the Community Giving Committee (CGC) for advisement and/or approval if a change to the grantees scope of work is required. In 2015, the Regulatory Affairs and Compliance Administrator position was created for the Independence at Home plan. This position manages compliance and regulatory activities for the plans Independence at Home department to ensure the plan continues to achieve and maintain compliance with federal, state, county and local regulatory and contractual requirements, including instances when the Plan relies on other agencies to help fulfill its Independence At Home mission. X X true true true true false false false false false false false Christopher Wing Chief Executive Officer 613351 0 426532 0 21473 0 1162962 0 18058 0 2242376 0 426532 0 William Roth President 440100 0 196239 0 21473 0 580675 0 34281 0 1272768 0 196239 0 Nancy Monk Chief Admin Officer 0 346990 0 92805 0 21377 0 373883 0 21410 0 856465 0 92805 Catherine Batteer SVP & GM All Scan Markets 333662 0 112707 0 21076 0 348069 0 1800 0 817314 0 112707 0 Sherry Stanislaw SVP & GM So Cal Market 292437 0 137786 0 20674 0 242198 0 14081 0 707176 0 112786 0 Peter Begans SVP Public & Government Affair 0 307396 0 131066 0 171349 0 244236 0 32000 0 886047 0 269659 Eve Gelb SVP Healthcare Services 253123 0 75494 0 18851 0 213397 0 26999 0 587864 0 75494 0 Timothy Schwab Former Chief Med & Vision 0 0 0 0 250552 0 0 0 0 0 250552 0 0 0 Romilla Batra Chief Medical Executive 315863 0 64420 0 18678 0 189509 0 10727 0 599197 0 63699 0 Sharonjit Jhawar VP Pharmacy 298069 0 71716 0 18570 0 172739 0 14093 0 575187 0 70995 0 Vinod Mohan chief financial officer 411018 0 129752 0 19212 0 427998 0 30687 0 1018667 0 29752 0 Janet Kornblatt Secretary 0 317993 0 62536 0 27449 0 352195 0 12900 0 773073 0 62536 Josh Goode Chief Technology Executive 0 284276 0 43266 0 18642 0 221927 0 23860 0 591971 0 43266 David Milligan SVP Sales 269494 0 61221 0 19327 0 219803 0 21532 0 591377 0 61221 0 Dan Osterweil Medical Director 310011 0 49444 0 26391 0 159006 0 3004 0 547856 0 48723 0 Kwan-Moon Leung SVP Healthcare Informatics 0 292470 0 99927 0 19502 0 240506 0 6550 0 658955 0 99927 Christian Zorn Outgoing VP Internal Audit 0 147659 0 50051 0 269404 0 18550 0 14682 0 500346 0 50051 Riaz Ali Chief Marketing Executive 260536 0 40188 0 18000 0 200363 0 24823 0 543910 0 0 0 Form 990 Schedule J - Part I, Line 1a SCAN Health Plan approved and paid for first class travel for CEO Chris Wing on 3 occasions where the flight was 4 hours or longer; Mr. Wing is six feet five inches tall and a regular airplane seat is extremely uncomfortable for long flights. The Star Rating System was established by Centers for Medicare and Medicaid Services (CMS) as part of an effort to help educate consumers on quality and make quality data more transparent and comparable between plans. Under the system CMS ranks health plans on a one- to five-star basis, weighing such factors as clinical outcomes, access to preventive services such as screenings and vaccines, managing chronic conditions, preventive care, and consumer satisfaction. Star ratings are calculated each year and may change from one year to the next. In 2015, SCAN Health Plan earned a 4.5 star rating from CMS; in acknowledgement of this achievement, all SCAN employees below senior vice president were awarded a net after tax Star bonus of $450.00 (the amount was grossed up for applicable taxes). Form 990 Schedule J - Part I, Line 3 Compensation for the CEO and CFO was established by a related organization and paid by the Company. The related organization used the following to establish the CEO and CFOs compensation: 1) Compensation Committee; 2) Independent Compensation Consultant; (3) Compensation Survey or Study; (4) Approval by the Board of Directors. Form 990 Schedule J - Part I, Line 4A During 2015 the employment relationship of the following employee of SCAN Group ended. In connection with the termination of his employment, SCAN Group negotiated and paid severance to the employee. The severance payment was in accordance with the terms of the highly compensated employees then existing employment agreement. Christian Zorn, Outgoing VP Internal Audit SCAN Group, $223,555 Form 990 Schedule J - Part I, Line 4B The Company provides a supplemental non-qualified retirement plan to officers and senior vice presidents via its section 457(f) plan. The following individuals participated in the companys section 457(f) plan during the year 2015: Christopher Wing, Peter Begans, Sherry Stanislaw, Catherine Batteer, Nancy J. Monk, William H. Roth, Moon Kwan-Leung, Eve Gelb, Janet Kornblatt, Vinod Mohan, Josh Goode, Riaz Ali and David Milligan. 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. 1) The participant has ten years of continuous employment, counting only service after December 31, 2005. 2) The participant reaches the age of 62 and has five years of continuous employment; 3) The participants involuntary termination; 4) The participants disability; or 5) The participants death. DEFERRED COMPENSATION FOR 2015, REPORTED ON SCHEDULE J, PART II, AND COLUMN C CONSISTS OF THE FOLLOWING: 1) 457(F) EMPLOYER CONTRIBUTIONS SUBJECT TO VESTING TERMS AND CONDITIONS AS NOTED IN ITEMS (1) THROUGH (5) ABOVE. 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 CONTRIBUTES TO UP TO THE COMPANY'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) THE COMPANY PROVIDES AN INCENTIVE PLAN TO DIRECTORS AND ABOVE. THERE ARE TWO COMPONENTS OF THE COMPANY INCENTIVE PLAN (ICP): A. ANNUAL ICP AWARD - Paid on or around April 1st of the subsequent year. B. DEFERRED ICP AWARD - BASED ON THE VESTING TERMS AND CONDITIONS FOR THIS COMPONENT, THERE IS SUBSTANTIAL RISK OF FORFEITURE. TIMOTHY SCHWAB IS LISTED AS FORMER CHIEF MEDICAL & VISION OFFICER ON SCHEDULE J. HE NO LONGER WORKS FOR THE ORGANIZATION. HOWEVER, HE RECEIVED A FINAL DISTRIBUTION FROM TRANSAMERICA IN 2015 OF $250,552 FOR THE 457(B) PLAN. Peter Begans received a distribution of $138,592 from the 457(f) Plan which was reported on Schedule J, Column B(iii). FORM 990, PART III, LINE 4A SCAN Health Care Services: SCAN Health Plan has a culture of quality and a long history of fulfilling our mission: Keeping seniors healthy and independent. As a Medicare Advantage and Prescription Drug Plan (MAPD) in California, SCAN collaborates with a network of delegated providers to offer Medicare and Medi-Cal covered health and behavioral healthcare and additional supplemental benefits. Our member-centric model of care ensures quality, individualized care for all members, including members with special needs such as members eligible for both Medicare and Medicaid, members with chronic conditions and frail members with functional deficits. The Health Care Services programs at SCAN are evidence-based and aligned with geriatric best practices. They include complex care management, advanced illness management, memory program, disease management and care navigation and coordination. The programs are aligned with the Institute for Healthcare Improvements Triple Aim and seek to ensure: - A safe and satisfying health care experience - Improved health outcomes for individuals and populations - Access and affordability for our members In general, population based quality activities are performed by SCANs Health Care Services department which includes a dedicated and highly qualified team of Registered Nurses and Masters prepared social workers, supported by an interdisciplinary team of nurses, social workers, gerontologists, a Board Certified Geriatrician, a Behavioral Health Specialist, and a Clinical Pharmacist. SCAN Health Plan supported the formation of The SCAN Foundation in 2007 with a contribution of $205 million; for calendar year 2015 the Foundation awarded grants in the amount of $5,951,203 and incurred program expenses in the amount of $11,670,129. In addition, SCAN Health Plan participates in numerous activities related to the care of seniors which provide significant community benefits including but not limited to the following: 1. Change a Life Foundation (Grant): One time grants to members and Independence At Home (IAH) clients for needed services not available otherwise (ramps, refrigerators, extensive dental work, bathroom modifications, wheelchair ramps, chair lifts). 2. Connecting Provider to Home: SCAN staff work with 4 medical groups to provide in home support through social worker and community health worker TEAMS TO ENCHANCE integration between the home and the physician. Serves members of other health plans as well as SCAN. Tests model that can be disseminated to multiple medical groups/health plans. 3. Council on Aging; Adopt-a-Senior: Provides holiday gifts for older and/or disabled residents of care facilities in Orange County. 4. Special Needs Plans Training: Conducted 2 hour webinar for providers on CMS Services for Special Needs Plan requirements, best practices, and how to be audit ready. 5. Provider education on compliance requirements to protect members from inappropriate denials. Annually, SCAN offers four 1-hour training sessions for medical groups to assist them in better practices around service denials. 6. Presentation: American Health Insurance Plans (AHIP) Conference on Medicare: Presentation to AHIP Medicare Conference about SCAN Health Risk Assessment (HRA) process. 7. Industry Collaboration Effort (ICE) Committee Participation: Approximately 27 staff members serve on 11 different Industry Collaboration Effort committees. These committees share best practices across health plans, including topics of Maximum Out of Pocket, Grievances and Appeals Improvement, Claims Standardization. Participation is on a volunteer basis. 8. Joint Presentation at ICE Conference-ICE Maximum Out of Pocket team: Presentation at 2015 ICE Conference: SCAN, along with the Centers for Medicare Services, Humana and Sharp Healthcare participated in a CMS panel session on the Organization, Determinations, Appeals and Grievances (ODAG) universe tables. Provided reminders and best practices for all delegates and other health plans. 9. Coding Quality Training: SCAN builds and disseminates training materials to other Health Plans and Medical Groups to use as part of their internal program development. 10. California State University Institute (CSU) Palliative Care Training for Medical groups: SCAN provided stipends for online Palliative Care training offered by CSU Institute for Palliative Care for a total of 8 staff from Monarch and Memorials palliative care teams. 11. Behavioral Health Webinars: SCAN sponsored two Behavioral Health Webinars, open to all Provider groups. Topics included: Medicare Covered Behavioral Health Benefits and Depression Care and Patient Health Questionnaire-9 (PHQ-9). Educates providers about covered mental health benefits and screening for depression. 12. Compassionate Care Coalition of California (CCCC): SCAN is an organizational member. The organization offers training, and consumer and provider materials to a variety of audiences in California. Training and support of advance care planning and Physician Ordered Life Sustaining Treatment (POLST). 13. Co-sponsorship of Leadership and Management in Geriatrics (LMG): SCAN sponsored and provided the Continuing Medical Education (CME) for the Leadership and Management in Geriatrics program. The two day conference trains clinicians to take on leadership roles in delivery of geriatric services. Course attendees include SCAN, other medical groups and health plans, and Geriatric Fellows. 14. Presentation at academic and policy Conferences: SCAN leadership prepare and present presentations at key policy and clinical conferences to improve care of older adults; educate professionals and share best practices, including Medicare Conferences, SNP Alliance, AHIP, American Geriatrics Society, California Accountable Physician Groups (CAPG). 15. Select Skilled Nursing Facility Network (SNF) Training for selected SNFs and St. Joes Hospital: Emergency Department and skilled nursing facility staff were trained on recognizing when it is appropriate for a patient to be admitted directly to a skilled nursing facility versus inpatient admission which results in better care for the patients. 16. CME credits for medical group physician education: Provided Continuing Medical Education for multiple medical group provider training sessions on 5 Star, Diabetes, ICE and Cultural Competency Provider training. 17. Pharmacy Interns from Pharmacy schools: UCSF and other pharmacy schools rotate Pharm D students for 6-16 weeks, through the SCAN Pharmacy Department training future pharmacists through engagement with pharmacy projects and case reviews. 18. Teaching Residents at UCI Medical School: Teaching residents both sensitizes them to the needs of older people and may encourage them to work with older people, which is a difficult area to attract physicians to. 19. Onboarding packet and webinar for Medical groups: SCAN developed a package of forms and established a process for bringing newly enrolled members into the health plan and acquainting them with how to make appointments and accessing services. This was followed by a webinar open to all medical groups. 20. California Quality Collaborative (CQC): CQC healthcare improvement organization is dedicated to advancing the quality and efficiency of the health care delivery system in California. The CQC will generate scalable and measurable improvement in care delivery. 21. California Association of Long Term Care Medicine (CALTCM), CEO and Board Member: CALTCM is an organization of professionals in the long term care field. The organization offers performance improvement education programs to improve the quality of care and professionalism of staff in long term care settings. 22. Service on Boards of Directors and Committees for industry groups i.e. Resource, Initiative and Society for Education (RISE), AHIP; RISE and other industry committees create policy and share best practices on subjects ranging from audit to encounter submission, and our employees are active members of a number of other groups. 23. Health Care Coding (HCC) University: Open to the public, Health Plans and Medical Groups can use information for their operations, provider interventions, and member interventions. 24. National Committee for Quality Assurance (NCQA) - Long Term Services and Supports, Advisory Committee Member: This committee assists NCQA with the development of quality standards for Long term services and supports (LTSS). 25. Community Substance Use/Misuse Training: Offered 3.5 hour community education on Substance Use issues in older adults-open to any professionals in the community. Teaches social workers and nurses how to identify substance use and intervene appropriately. Continuing education units offered. 26. San Joaquin Health Needs Assessment Steering Committee: Steering Committee for San Joaquins Mobilizing for Action through Planning and Partnerships Initiative. Committee develops an assessment for San Joaquin County community members, id FORM 990, PART III, LINE 4B Independence at Home: SCAN'S MISSION OF KEEPING SENIORS HEALTHY AND INDEPENDENT IS NOT LIMITED TO SCAN MEMBERS. SCAN RECOGNIZES ITS RESPONSIBILITY TO ENHANCE THE QUALITY OF LIFE FOR ALL THOSE IN THE COMMUNITES WE SERVE. TO THAT END, SCAN SPONSORS AND PROMOTES INNOVATIVE GERIATRIC RESEARCH, INVESTS IN SIGNIFICANT COMMUNITY EDUATION AND OUTREACH EFFORTS, AND SUPPORTS LIKE-MINDED COMMUNITY ORGANIZATIONS THROUGH GRANTS. THE CORNERSTONE OF SCAN'S COMMUNITY ENGAGEMENT COMES THROUGH INDEPENDENCE AT HOME (IAH). THROUGH THE PROGRAMS RUN BY IAH, SCAN HAS CONNECTED WITH THOUSANDS OF SENIORS AND CAREGIVERS ACROSS ITS SERVICE AREAS. TODAY'S INDEPENDENCE AT HOME PROGRAMS ARE SUPPORTED BY FUNDING THROUGH THE STATE AND FROM SCAN HEALTH PLAN. THE PROGRAMS ARE GEARED TO SUPPORTING THE UNDERSERVED, FRAIL AND DISABLED SENIORS IN OUR COMMUNITY. IAH'S HALLMARK PROGRAMS ARE: -MULTIPURPOSE SENIOR SERVICES PROGRAM (MSSP): THIS PROGRAM PROVIDES LONG-TERM IN-HOME CARE MANAGEMENT FOR ADULTS 65 PLUS WHO QUALIFY FOR MEDI-CAL. THIS PROGRAM WAS FIRST STARTED IN 1977. -SUPPORTIVE SERVICES PROGRAM (SSP): THIS PROGRAM INCLUDES CARE MANAGEMENT, PLANNING, AND DAILY LIVING ASSISTANCE SERVICES FOR FUNCTIONALLY IMPAIRED OLDER ADULTS. -LOS ANGELES COUNTY'S LINKAGE PROGRAM: THIS PROGRAM PROVIDES CARE MANAGEMENT, CARE PLANNING, COMPREHENSIVE INFORMATION, AND SERVICE ARRANGEMENTS FOR FRAIL, AT-RISK ADULTS. -INNERLINKS ADVANTAGE (IA): THIS PROGRAM PROVIDES IN-HOME MENTAL HEALTH SUPPORT. -CALIFORNIA COMMUNITY TRANSITIONS (CTT): THIS PROGRAM ASSISTS WITH THE SAFE TRANSITION FROM HEALTHCARE FACILITIES BACK TO COMMUNITY LIVING. -FAMILY CAREGIVER SUPPORT PROGRAM (FCSP): THROUGH THIS PROGRAM, FAMILY CAREGIVERS RECEIVE INFORMATION, TRAINING, COUNSELING, CARE MANAGEMENT, RESPITE AND COMMUNITY RESOURCE REFERRALS. IN 2015, SCAN COMBINED ITS COMMUNITY GIVING PROGRAM AND COMMUNITY OUTREACH PROGRAM WITH INDEPENDENCE AT HOME. SCAN COMMUNITY GIVING PROGRAM: SCAN'S COMMUNITY GIVING (CG) PROGRAM IS FOCUSED ON MEETING AN INDIVIDUAL'S BASIC NEEDS INCLUDING NUTRITION, SHELTER, HEALTH AND SOCIALIZATION, AND ON ENHANCING AN INDIVIDUAL'S ABILITY TO REMAIN INDEPENDENT IN THEIR OWN COMMUNITY. THIS IS ACCOMPLISHED THROUGH ONE-TIME OPERATING GRANTS. THE SCAN COMMUNITY GIVING COMMITTEE IDENTIFIES ORGANIZATIONS WHOSE MISSION ALIGNS WITH THE PROGRAM PRIORITIES. AS A RESULT OF THIS APPROACH, THE MAJORITY OF GRANTEES ARE IDENTIFIED AND CONTACTED BY OUR STAFF. POLICIES AND PROCEDURES: A. IDENTIFICATION AND VETTING OF POTENTIAL PROGRAM GRANTEES - DIRECTOR, COMMUNITY OUTREACH, COLLABORATES WITH VARIOUS SCAN HEALTH PLAN DEPARTMENTS (I.E., HEALTH CARE SERVICES, AND INDEPENDENCE AT HOME) AND REPUTABLE AGENCIES TO IDENTIFY PROSPECTIVE GRANTEE ORGANIZATIONS. THE PROSPECTIVE GRANTEES UNDERGO THE CG VETTING PROCESS AND ARE MEASURED AGAINST THE FOLLOWING CRITERIA: 1) ALIGNMENT WITH THE SCAN HEALTH PLAN MISSION; 2) MUST BE A VERIFIED NONPROFIT OR GOVERNMENTAL AGENCY WITH TAX-EXEMPT STATUS; AND, 3) THE ORGANIZATION MUST BE AT LEAST TWO YEARS OLD. SUCCESSFUL CANDIDATES ARE ADDED TO THE LARGER SCAN HEALTH PLAN GRANTEE POOL. B. SHORT LISTING POTENTIAL GRANTEE - DIRECTOR, COMMUNITY OUTREACH AND MANAGER, COMMUNITY OUTREACH AND GIVING, USE VARIOUS METHODS, INCLUDING OUTBOUND CALLS, INTERNET RESEARCH, AND INDUSTRY RATINGS TO REVIEW THE POTENTIAL GRANTEE POOL AND GENERATE A SHORTLIST. C. EVALUATION AND SELECTING OF GRANTEES BY THE COMMUNITY GIVING COMMITTEE (CGC) - THE CGC IS A NINE-MEMBER COMMITTEE REPRESENTATIVE OF ALL LEVELS OF MANAGEMENT AND CHAIRED BY THE VICE-PRESIDENT OF INDEPENDENCE AT HOME (IAH). THE CGC MEETS ON A QUARTERLY BASIS AND ITS ROLE IS TWOFOLD: 1) EVALUATE, SELECT, AND DECIDE THE AMOUNT TO BE AWARDED TO THE GRANTEE ORGANIZATIONS, AND, 2) STEER THE CG PROGRAM. THE CGC BASES ITS DECISION TO MAKE AWARDS ON THE INFRASTRUCTURE OF THE GRANTEE ORGANIZATION, AND ITS PERCEIVED ABILITY TO EFFECTIVELY AND EFFICIENTLY IMPACT THE LIVES OF SENIORS AND CONTINUE A SUSTAINABLE RELATIONSHIP. D. GRANTEE OUTREACH - SUBSEQUENT TO THE CGC EARMARKING AND APPROVING GRANT FUNDS, THE MANAGER, COMMUNITY OUTREACH AND GIVING, PLACES AN OUTREACH CALL TO THE PROSPECTIVE GRANTEE ORGANIZATION. THE GRANTEE ORGANIZATION IS INFORMED OF ITS SELECTION TO APPLY FOR A ONE-TIME GRANT VIA OUR ONLINE GRANT TRACKING SYSTEM. THE MANAGER, COMMUNITY OUTREACH AND GIVING, REVIEWS EACH APPLICATION AND DISCUSSES CRITERIA WITH THE DIRECTOR, COMMUNITY OUTREACH, IN ORDER TO MAKE A RECOMMENDATION FOR FUNDING. THE LIST OF RECOMMENDED GRANTEES IS SUBMITTED TO THE CGC EACH QUARTER TO BE DISCUSSED AND VOTED ON. A GRANT AGREEMENT IS DEVELOPED FOR EACH APPROVED GRANT, WHICH CONTAINS INFORMATION ON FUNDING RESTRICTIONS AND REQUIREMENTS FOR GRANT REPORTING. ONLY AFTER A SIGNED AGREEMENT HAS BEEN FULLY EXECUTED WILL THE GRANT PAYMENT PHASE BE INITIATED. E. PAYMENT OF GRANT - THE MANAGER, COMMUNITY OUTREACH AND GIVING, PREPARES A COVER LETTER, ENVELOPE, AND CHECK REQUEST FORM WHICH IS SIGNED AND APPROVED BY THE VICE PRESIDENT, INDEPENDENCE AT HOME, AND FORWARDED TO ACCOUNTS PAYABLE FOR PROCESSING. ACCOUNTS PAYABLE DISBURSES PAYMENT. F. ALL GRANTEES SUBMIT A QUARTERLY REPORT DOCUMENTING METRICS AND PERFORMANCE YEAR- TO - DATE THROUGHOUT THE DURATION OF THE FUNDING. THE MANAGER, COMMUNITY OUTREACH AND GIVING, TRACKS THE REPORTS AND REVIEWS TO ENSURE COMPLIANCE. THE MANAGER ADDRESSES ISSUES WITH THE GRANTEE TO IDENTIFY THE CAUSE AND ANY REMEDIATION REQUIRED. ISSUES WITH COMPLIANCE ARE RAISED TO THE VICE PRESIDENT, IAH, WHO WILL ASSIST WITH REMEDIATION OR ELEVATE TO THE CGC FOR ADVISEMENT AND/OR APPROVAL IF A CHANGE TO THE GRANTEE'S SCOPE OF WORK IS REQUIRED. SCAN'S VOLUNTEER ACTION FOR AGING: THROUGH THIS PROGRAM, SCAN RECRUITS, TRAINS AND MANAGES VOLUNTEERS. IN 2015, THROUGH THIS PROGRAM, VOLUNTEERS IN THE COMMUNITY DONATED OVER 6,000 HOURS TO COMPLETE 100 "FRIENDLY VISITOR" PROGRAMS, HOSTED 376 COMMUNITY EVENTS, AND DELIVERED 2,403 THANKSGIVING MEALS. SCAN COMMUNITY OUTREACH: SCAN HEALTH PLAN HAS A LONG (35 PLUS YEARS) HISTORY OF CREATING PROGRAMS AND PROVIDING SERVICES TO OLDER ADULTS AND THEIR CAREGIVERS. OUR EXPERIENCE WITH THIS SEGMENT OF THE POPULATION HAS ALLOWED US TO DEVELOP A UNIQUE EXPERTISE IN GERIATRIC CARE AND HEALTH INTERVENTIONS. SCAN HEALTH PLAN IS COMMITTED TO SHARING THIS SET OF SKILLS AND KNOWLEDGE WITH THE BROADER COMMUNITY BY DEVELOPING COMMUNITY OUTREACH INITIATIVES. THESE INITIATIVES ARE AN IMPORTANT TOOL FOR BRINGING EDUCATION DIRECTLY TO COMMUNITY MEMBERS, AS WELL AS CONTRIBUTING TO REDUCING HEALTH DISPARITIES, AND IMPROVING HEALTH LITERACY, IN PARTICULAR AMONG UNDERSERVED COMMUNITIES. THROUGH OUR OUTREACH ACTIVITIES AND COMMUNITY GIVING PROGRAM, WE WORK TO SUPPORT ACCESS TO BASIC NEEDS SUCH AS FOOD AND NUTRITION, TO ENCOURAGE ACTIVE AND HEALTHY LIFESTYLES, TO ENGAGE OLDER ADULTS IN HEALTH MAINTENANCE, AND TO COLLABORATE WITH LOCAL SERVICE PARTNERS TO MEET GAPS IN COMMUNITY SERVICES. WE DO THIS IN MANY WAYS, BRINGING NEEDED RESOURCES AND A THOUGHTFUL PRESENCE TO OLDER ADULTS AND THEIR SUPPORT NETWORKS THROUGHOUT CALIFORNIA. OUR GOAL IS TO MAKE AN IMPACT IN ALL OF THE COMMUNITIES WE SERVE AND TO IMPROVE THE LIVES OF ALL SENIORS - NOT JUST SCAN MEMBERS. SCAN RECOGNIZES THAT ITS RESPONSIBILITY TO THE COMMUNITIES WE SERVE GOES BEYOND BUSINESS AND PROVIDING QUALITY HEALTHCARE. OUR COMMUNITY OUTREACH PROGRAM AND INDEPENDENCE AT HOME (IAH) DEPARTMENT SHARE THE SAME GOALS AND PERFORM MANY OF THE SAME COMMUNITY FUNCTIONS; THEREFORE REFLECT GREATER CONSISTENCY AND IMPACT. IN 2015, HEALTH AND WELLNESS PARTICIPATED IN 149 EVENTS. 73 HEALTH SCREENINGS WERE PROVIDED. THE SCAN RV/VAN PARTICIPATED IN 30 EVENTS AND ATTENDED 72 EVENTS HOSTING TABLES FOR EDUCATION AND INFORMATION. ADDITIONALLY, THERE WERE 65 TRADING AGES PRESENTATIONS TO KEY ORGANIZATIONS SUCH AS: RSVP LOS ANGELES, ONEOC, ORANGE COUNTY OMBUDSMEN, CSU LONG BEACH- SCHOOL OF GERONTOLOGY, LAKEWOOD HIGH SCHOOL STAFF, USC SCHOOL OF ARCHITECTURE, USC SCHOOL OF GERONTOLOGY, CSU NORTHRIDGE, LOGISTICARE (SCAN TRANSPORTATION VENDOR), GARY MARY WEST FOUNDATION- SAN DIEGO, KECK SCHOOL OF MEDICINE, ALPERT JEWISH COMMUNITY CENTER, NATIONAL CENTER ON ELDER ABUSE, AND LIVING OPPORTUNITY MANAGEMENT COMPANY (LOMCO) SERVICE COORDINATORS. IN 2015, SCAN GAVE 32 GRANTS IN 10 COUNTIES, AND SUPPORTED 60 ORGANIZATIONS THROUGH SPONSORSHIPS. FOR THE YEAR ENDING DECEMEBER 31, 2015 SCAN INCURRED $12,244,668 IN COMMUNITY PROGRAM EXPENSES INCLUDING IAH, AND RECEIVED $3,742,566 IN GRANTS. FORM 990, PART III, LINE 4C Provider Integration Program: SCAN has long recognized the importance of the provider network in supporting our mission to keep seniors healthy and independent and that our members highly value their relationship with their physicians. This appreciation led SCAN to charter the SCAN Provider Integration Steering Committee, with membership coming from the clinical and operational leaders of our key physician groups and health systems. A main area of focus for this effort has been quality improvement, supporting 5 Star performance metrics. SCAN and the provider organization leaders recognize that if we are to succeed in the CMS Medicare Advantage 5 Star program we must do so as a collective system. We share 5 Star metrics data that highlights individual physician group performance on HEDIS and Part D quality measures, supporting identification of best practices within the SCAN provider network. We invite the providers to share their best quality improvement practices with their colleagues from other provider organizations, hosting a webinar series several times a year with a best practice organization leading the webinar, sharing their approaches and lessons learned. We have also worked with UCLA Geriatric Medicine researchers to promote best practice identification and implementation in the areas of end of life care and chronic disease management. This effort culminated in a process within which the Provider Integration physician groups were supported in implementing an identified best practice. UCLA presented the results of this research at the Gerontological Society of America and the American Association Public Health Association annual national meetings. SCAN supports advances in care for seniors by working closely with our provider networks to support their efforts, knowing that the work they do to improve systems and processes of care will benefit their entire patient population. For the year ending December 31, 2015 the Provider Integration Program incurred $400,397 in program expenses. FORM 990, PART VI, LINE 6 The sole member of the organization is SCAN Group, a California nonprofit public benefit corporation. FORM 990, PART VI, LINE 7A The sole member has the power to appoint the members of the board of directors. FORM 990, PART VI, LINE 11B The Form 990 is prepared by BDO USA, LLP working in conjunction with SCANs Finance department. SCAN Health Plans 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 and ensures accuracy of descriptions and that disclosure is complete. The draft Form 990 is reviewed in pertinent part by the Compensation Committee of the Board; the Form 990 is reviewed in its entirety by the Audit and Compliance Committee of the Board of Directors of SCAN Group and all members of the Board of Directors after it is prepared for filing, but prior to filing. FORM 990, PART VI, LINE 12C SCAN Health Plan regularly and consistently monitors and enforces compliance with its Conflict of Interest policy through annual circulation of a Conflict of Interest questionnaire which all members of the Board of Directors, officers and members of executive management must complete and sign. In addition, there is annual mandatory compliance education and training. SCANs Compliance Department is responsible for enforcement of SCANs robust compliance program and SCANs Policies and Procedures. Members of the Executive Team also have responsibility for enforcement. The legal department of SCAN Group reviews all contractual relationships entered into by the organization and SCANs General Counsel is responsible for monitoring the Conflicts of Interest questionnaire. The legal department of SCAN Group monitors and enforces adherence to these policies on an ongoing basis. FORM 990, PART VI, LINE 15A & B 15a: The process for determining the compensation of the Chief Executive Officer (CEO) of SCAN Health Plan is conducted by the Compensation Committee of the Board of Directors of SCAN Group, all the voting members of which are independent persons. In determining the compensation of the CEO, 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 determining the CEOs 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 considered comparable to SCAN Health Plan based upon certain industry standard metrics. The Compensation Committee deliberates on the issue of the CEOs compensation package in consideration of the Ernst & Young Executive Compensation Report. 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 Group regarding the compensation package for the following year. The full Board of Directors of SCAN Group deliberates on and then votes on such recommendation; the Chief Executive Officer is recused for the entirety of such deliberations and vote. The minutes of the Compensation Committee and the Board of Directors for these meetings are prepared substantially contemporaneously and substantiate such deliberations and decisions. 15b: The process for determining the compensation of officers and key employees of SCAN Health Plan is conducted by the Human Resources Department 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 Committee are independent persons. In determining each employee's compensation, the Human Resources Department and Compensation Committee work with and rely 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 considered comparable to SCAN Health Plan and SCAN Group based on various metrics. The Chief Executive Officer (CEO) makes a recommendation to the Compensation Committee with respect to each employees compensation package in light of the Ernst & Young Executive Compensation Report. At the Compensation Committee meeting addressing such matters, questions are asked of, and answered by Ernst & Young, regarding their report and other matters relevant to the 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 substantiate such deliberations and decisions. FORM 990, PART VI, LINE 19 - GOVERNANCE SCAN Health Plans governing documents and conflict of interest policy are not made available to the public. SCAN Health Plans audited financial statements are publicly available through the Department of managed health cares website and tax returns are available on request. FORM 990, PART XI, LINE 9 - OTHER CHANGES IN NET ASSETS On November 30, 2015, SCAN Health Plan transferred $75 million to SCAN Group to FUND STRATEGIC PROJECTS RELATED TO SCAN'S MISSION, INCLUDING CHARITABLE PROGRAMS. SCAN Health Plan is not obligated to make future transfers. FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL SERVICES TOTAL FEES:1921369886 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER FEES TOTAL FEES:26446899 SCAN GROUP 3800 KILROY AIRPORT SUITE 100 LONG BEACH CA 90806 953826037 ADMIN SUPPORT CA 501(C)(3) 11b NA true THE SCAN FOUNDATION 3800 KILROY AIRPORT SUITE 400 LONG BEACH CA 90806 450552845 GRANT MAKING CA 501(C)(3) 11b SCAN GROUP true SCAN HEALTH PLAN ARIZONA 3800 KILROY AIRPORT SUITE 100 LONG BEACH CA 90806 731729007 MEDICARE ADV AZ 501(C)(4) N/A SCAN GROUP true SCAN Health Check Assessment Centers 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 462962358 healthcare CA NA C CORP 0 0 true SCAN CALIFORNIA MANAGEMENT COMPANY 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 462951831 MANAGEMENT CA SCAN Group C CORP 0 0 true false true false false false false false false false false false false false false false true true false false SCAN HEALTH PLAN ARIZONA Q 1222686 See Part VII The SCAN Foundation Q 32143 See Part VII SCAN Group P 73403318 See Part VII SCAN Group B 75000000 Funds Transfer SCHEDULE R, PART V The percentage of allocation to affiliated companies is determined based on estimated percentage of time worked, percentage of SCAN membership, and the percentage of bid submissions, as appropriate based on the nature of the expense.