2016-11-10T17:21:59-06:00 2015-12-31 910189318 Moss Adams LLP 805 SW Broadway Ste 1200 Portland OR 97205 990 2015-01-01 453321455 Oregon's Health CO-OP OREG 6126299079 220 NW Second Avenue No 600 Portland OR 97209 Jan Moenck SPECIAL DEPUTY RECEIVER 6126299079 2016-11-09 1 Wendy Campos P00448102 5032421447 2016-11-08 2015 2017-02-10 21:41:12Z JAN MOENCK 20 Batterson Park Rd 300 Farmington CT 06032 64391623 0 X WWW.OHCOOP.ORG X 2011 OR OREGON'S HEALTH CO-OP IS A NONPROFIT PUBLIC BENEFIT CORPORATION OPERATING EXCLUSIVELY AS A CONSUMER OPERATED AND ORIENTED HEALTH PLAN AS DEFINED UNDER SECTION 1322 OF THE AFFORDABLE CARE ACT. THE CORPORATION OFFERS HEALTH CARE INSURANCE AND SERVICES TO INDIVIDUALS AND BUSINESSES ON AND OFF THE OREGON HEALTH INSURANCE EXCHANGE. THE ORGANIZATION CEASED CONDUCTING OPERATIONS AS A HEALTH INSURANCE CARRIER AS OF JULY 31, 2016. EFFECTIVE JULY 11, 2016, OREGON'S HEALTH CO-OP WENT INTO STATE RECEIVERSHIP AND ALL POLICIES WERE TERMINATED AS OF JULY 31, 2016. WIND-DOWN OF THE OPERATIONS IS FORTHCOMING. 12 12 49 15 0 0 0 0 4280560 53751482 211541 283327 0 0 4492101 54034809 0 0 0 0 1995874 3589402 0 0 0 9277501 68882488 11273375 72471890 -6781274 -18437081 18683322 45615668 36397391 81768357 -17714069 -36152689 X OREGON'S HEALTH CO-OP IS A NONPROFIT PUBLIC BENEFIT CORPORATION OPERATING EXCLUSIVELY AS A CONSUMER OPERATED AND ORIENTED HEALTH PLAN AS DEFINED UNDER SECTION 1322 OF THE AFFORDABLE CARE ACT. THE CORPORATION OFFERS HEALTH CARE INSURANCE AND SERVICES TO INDIVIDUALS AND BUSINESSES ON AND OFF THE OREGON HEALTH INSURANCE EXCHANGE. 0 0 Oregon's Health Co-Op, a nonprofit commercial health insurance issuer, established to operate as a consumer operated and oriented plan as defined by the Affordable Care Act (ACA), sells health insurance coverage to individuals, small groups and large groups. During 2014, the Company operated on the State run Marketplace under the ACA, Cover Oregon. The Company provides coverage in all counties of the state and offers health insurance plans for individuals and small groups within the Marketplace and for individuals, small groups and large groups outside the Marketplace. In 2015, a bill was passed to dissolve Cover Oregon and transfer responsibilities for the Oregon exchange to the state Department of Consumer and Business Services, which utilizes the federally run Marketplace. (continued on Schedule O)The Company utilizes the Federal Marketplace for the 2015 plan year. The CO-OP program was established by the ACA to foster the creation of new consumer-governed, private, nonprofit health insurance issuers. Oregon's Health CO-OP's health coverage offered to members is innovative and progressive, and it serves its members by creating better health, improving member experience and reducing overall costs. 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 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 0 0 0 1 1961 0 1 49 1 0 0 0 0 0 0 2500000 21297042 0 X 12 12 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 0 0 OR X JAN MOENCK 6126299079 220 NW Second Ave 600 Portland OR 97209 Ira Zarov Chair 5.00 X X 0 0 0 DEBORAH TOMPKINS Prior Chair 5.00 X X 0 0 0 Susan King Secretary 3.00 X X 0 0 0 Henry Chip Lazenby Director 3.00 X 0 0 0 Erik Isaacman Director 3.00 X 0 0 0 Hilary Bradbury Director 3.00 X 0 0 0 Andrew Kyler Prior Director 3.00 X 0 0 0 Elle Abbott Director 3.00 X 0 0 0 Keri Abbott Director 3.00 X 0 0 0 Christine Ford Director 3.00 X 0 0 0 Tom Gifford Director 3.00 X 0 0 0 Debra McCurry Director 3.00 X 0 0 0 Asawari Mokashi Director 3.00 X 0 0 0 Thomas Gragnola Prior Director 3.00 X 0 0 0 Bjorn Borstelmann Prior director 3.00 X 0 0 0 Phil Jackson President & CEO 40.00 X 147553 0 4698 DR RALPH PROWS Prior PRESIDENT & CEO 40.00 X 203649 0 45534 Peggy Worley CFO 40.00 X 128832 0 29043 Peggy Grunden Prior TREASURER & CFO 40.00 X 220794 0 48694 William Donahue Prior Director of Provider Services 40.00 X 137471 0 16673 Colleen Nelson Chief Compliance Officer 40.00 X 163069 0 18684 Robert Sumner Director of Sales 40.00 X 179817 0 14833 Jeff Markle Director of Member Experience 40.00 X 165062 0 32962 Lila Kemnitz Sales Manager 40.00 X 104799 0 13362 1451046 0 224483 9 0 1 0 Valence Health 540 W Madison st Chicago IL 60661 Third-Party Administrative Services 3402042 Online Insight 375 Northridge Rd Suite 270 Atlanta GA 30350 payment portal & processing 486193 Valley Insurance Professionals 5022 Commercial St SE Salem OR 97306 Commissions - Insurance Broker 402495 The Atum Group LLC PO Box 15176 Portland OR 97293 Project manager & Business Analysis 356629 HealthPlanOne 35 Nutmeg Drive Ste 220 Trumbull CT 06484 Member Acquistion Services 352053 6 premium revenue 524114 53751482 53751482 53751482 279512 279512 10360629 10356814 3815 3815 3815 54034809 53751482 0 283327 828796 2283772 30267 241980 204587 4197517 100456 43500 1710873 852886 2515004 187416 85024 54021 70253 64220 97733 medical claims paid 56157585 Change in reserves 2746000 72471890 1597962 5097103 22922 38811 242185 465694 267690 127659 154829 140031 14699831 26211797 1965593 13662232 18683322 45615668 1059942 1497004 29679400 58856900 5658049 21414453 36397391 81768357 X 0 0 0 0 -17714069 -36152689 -17714069 -36152689 18683322 45615668 -18437081 -1539 0 X 0 1 X 1 1 1 267690 127659 140031 140031 Accrued Investment income 143912 Amounts receivable related to uninsured plans 665294 Premiums Receivable 1334963 Reinsurance Receivable 6821957 HEALTHCARE AND OTHER AMOUNTS RECEIVABLE 256352 Other non-invested assets 4319004 Other assets 120750 13662232 Aggregate Health policy reserves 5113000 Premiums receIved in advance 2427040 Healthcare Payables 12964100 Ceded Reinsurance Premiums Payable 572416 other liabilities 337897 21414453 X 54034809 0 54034809 0 54034809 72471890 0 72471890 0 72471890 Part X, Line 2: THE COMPANY IS TAX EXEMPT PURSUANT TO THE UNITED STATES INTERNAL REVENUE CODE (IRC) SECTION 501(C)(29), THOUGH IT WOULD BE SUBJECT TO TAX ON INCOME UNRELATED TO ITS EXEMPT PURPOSE (UNLESS THAT INCOME IS OTHERWISE EXCLUDED BY THE IRC). The Company had no unrelated income during the year ended December 31, 2015 and 2014. X X X 1 0 0 Phil Jackson President & CEO 137033 0 0 0 10520 0 2915 0 1783 0 152251 0 0 0 DR RALPH PROWS Prior PRESIDENT & CEO 158598 0 45000 0 51 0 39000 0 6534 0 249183 0 0 0 Peggy Worley CFO 128219 0 0 0 613 0 13735 0 15308 0 157875 0 0 0 Peggy Grunden Prior TREASURER & CFO 205510 0 14667 0 617 0 42000 0 6694 0 269488 0 0 0 William Donahue Prior Director of Provider Services 137417 0 0 0 54 0 12120 0 4554 0 154145 0 0 0 Colleen Nelson Chief Compliance Officer 162511 0 0 0 558 0 3376 0 15308 0 181753 0 0 0 Robert Sumner Director of Sales 174939 0 4250 0 628 0 3602 0 11231 0 194650 0 0 0 Jeff Markle Director of Member Experience 164500 0 0 0 562 0 22048 0 10913 0 198023 0 0 0 Part I, Line 4a Peggy Grunden, Prior Treasurer & CFO - $93,285 William Donahue, Prior Director of Provider Services - $12,308 Form 990, Part V, Line 13a OR Form 990, Part VI, Section A, line 6 oregon's health co-op has one class of members. Each individual over the age of 18 years who is covered under a health insurance policy issued by the corporation is qualified to be a member of the corporation. Since no policies have been issued, the bylaws name the Formational Board as interim qualified members. Form 990, Part VI, Section A, line 7a The Formational Board can elect additional Formational Board members. Members will elect an Operational Board. There are limitations on voting rights of members in the bylaws. No member shall have the right to be entitled to vote: a) on a sale, lease, exchange, or other disposition of assets; b) on a merger; c) on dissolution or reorganization; or d) on amendments to the corporation's Articles of Incorporation or Bylaws. Form 990, Part VI, Section B, line 11 Oregon's health Co-Op's CFO and Receiver review the final Form 990 prior to filing. Form 990, Part VI, Section B, line 12c The Conflict of Interest policy of Oregon's Health Co-op is distributed annually and applies to the following covered persons: Any Director, CEO, CMO, CFO, Controller, Other Key Employee or any other individual in a position to exercise significant influence over a decision having economic implications for Oregon's Health Co-op. The Conflict of Interest policy is reviewed and discussed at an annual Board meeting and each person signs an agreement to follow the policy. Oregon's Health Co-op annually circulates questionnaires to covered persons to determine independence and discover family and business relationships, and the Chairperson of the Board of Directors diligently reviews these forms and compiles and maintains a list of potentially conflicted entities and individuals. The Chairperson of the Board continually monitors proposed or ongoing transactions against this list as a means of identifying and screening for possible conflicts. The Chairperson of the Board deals with potential or actual conflicts, before, during and/or after the transaction has occurred, depending on the circumstances of the conflict. All signed Conflict of Interest policies and Questionnaires are retained at Oregon's Health Co-op's office. In the event of a potential conflict of interest, a covered person must disclose the existence of his or her financial interest and must be given the opportunity to disclose all material facts to the Board of Directors, members of committees with board delegated powers, and to executive officers who are considering the proposed transaction or arrangement. Following the disclosure of the financial interest and all material facts, and after any discussion with the interested person, he/she leaves the meeting while the Board or Committee independently discusses and votes on the matter before it. In the event that a conflict of interest is identified, the Chairperson of the Board or Committee shall appoint a disinterested person or committee to investigate alternatives to the proposed transaction or arrangement. After exercising due diligence, the Board or Committee will determine whether Oregon's Health Co-op can obtain a more advantageous transaction or arrangement with reasonable efforts from a person or entity that would not give rise to a conflict of interest. If a more advantageous transaction or arrangement is not reasonably attainable, the Board or Committee will determine by majority vote of the disinterested Directors or Committee members whether the transaction or arrangement is in Oregon's Health Co-op's best interest. Persons with a conflict are prohibited from participating in the governing body's deliberations and decisions about the transaction. Form 990, Part VI, Section B, line 15a THE ANNUAL COMPENSATION FOR Oregon's Health Co-op's CEO WAS DETERMINED BASED ON A MARKET STUDY OF COMPARABLE DATA AND APPROVED AND DOCUMENTED BY THE INDEPENDENT BOARD OF DIRECTORS. Form 990, Part VI, Section C, line 19 While no requirement to make its governance documents, conflict of interest policy and financial statements available to the public exists, Oregon's Health Co-op will consider all requests for these documents on a case by case basis.