2016-11-04T17:31:45-05:00 2015-12-31 BDO USA LLP 600 ANTON BLVD STE 500 COSTA MESA CA 92626 990 2015-01-01 731729007 SCAN HEALTH PLAN ARIZONA % VIRGINIA HAVAI SCAN 5629895100 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 908065616 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 AIRPORT WAY 100 LONG BEACH CA 90806 72814422 false X WWW.SCANHEALTHPLAN.COM/ARIZONA/MEDICARE/ X 2006 AZ TO SERVE AND TO IMPROVE THE LIVES OF THE FRAIL, ELDERLY AND DISABLED RESIDENTS OF ARIZONA. 3 0 16 0 0 0 0 159090188 72675105 75286 51071 50025148 -13790 209190622 72712386 0 0 0 0 1535288 841134 0 0 0 165171838 67028372 166707126 67869506 42483496 4842880 27766641 34226665 6693469 8324573 21073172 25902092 X TO SERVE AND IMPROVE THE LIVES OF THE FRAIL, ELDERLY AND DISABLED RESIDENTS OF ARIZONA BY PROVIDING MEDICAL AND PHARMACY SERVICES, COORDINATED CARE, SOCIAL SERVICES AND OTHER SERVICES TO A GERIATRIC POPULATION THAT IS UNDERSERVED AND AT RISK. false true 62332722 72675105 Program Services Description provided in Schedule O 62332722 false false false false false false false false false true false false false true true true true false false false false false false false false false false false true false false false false false false false false false false false false false true true true false true 324 0 true 16 true false false false false false false false false false false X 3 0 false false false false true true false true true false false true true true true true true true true false AZ X VIRGINIA HAVAI 5629895100 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 X CHRISTOPHER WING DIRECTOR/CHAIRMAN 2.0 38.0 X X 0 1061356 1181020 CATHERINE BATTEER DIRECTOR/PRESIDENT 2.0 38.0 X X 0 467445 349870 WILLIAM ROTH DIRECTOR 2.0 38.0 X 0 657812 614955 VINOD MOHAN CHIEF FINANCIAL OFFICER 2.0 38.0 X 0 559982 458685 JANET KORNBLATT SECRETARY 2.0 38.0 X 0 407978 365095 WENDY KARSTEN OUTGOING VP GENERAL MANAGER 40.0 0.0 X 180335 0 1986 RICHARD PEITZMEIER VICE PRESIDENT - SALES 40.0 0.0 X 244717 0 110017 KAREN SUGANO CORPORATE VP GENERAL MANAGER 8.0 32.0 X 0 367201 66628 RUSSELL BROWER CHIEF MEDICAL DIRECTOR 1.0 39.0 X 0 381114 137020 ANDREW WHITELOCK CHIEF RISK EXECUTIVE 8.0 32.0 X 0 267022 22122 425052 4169910 3307398 2 false true false HEALTHCARE PARTNERS ARIZONA LLC 19191 S VERMONT AVENUE STE 200 TORRANCE CA 90502 MEDICAL SERVICES 18779697 EXPRESS SCRIPTS INC 21653 NETWORK PLACE CHICAGO IL 606731216 MEDICAL SERVICES 15134046 LIFEPRINT ARIZONA PO BOX 46770 LAS VEGAS NV 89114 MEDICAL SERVICES 33783096 Professional Healthcare Network LL 7600 NORTH 16th ST STE 140 PHOENIX AZ 85020 MEDICAL SERVICES 350390 AMERICAN HEALTHWAYS SERVICES 1445 S SPECTRUM BLVD SUITE 100 CHANDLER AZ 92307 MEDICAL SERVICES 279976 9 0 MEDICARE PREMIUMS 900099 72675105 72675105 72675105 61361 61361 0 0 77956 91746 -13790 0 -13790 -13790 0 10290 -10290 -10290 -10290 0 0 0 0 72712386 72675105 37281 X 0 0 0 0 537010 537010 0 154359 154359 35795 35795 56354 56354 57616 57616 2264854 2264854 13239 13239 68134 68134 26000 26000 0 0 64258644 62332722 1925922 0 175357 175357 24986 24986 4005 4005 0 85193 85193 39917 39917 0 1050 1050 0 0 49292 49292 0 LICENSE AND PERMITS 6748 6748 FEDERAL, STATE, COUNTY TAXES 5600 5600 ALL OTHER EXPENSES 5353 5353 67869506 62332722 5536784 0 110147 -80496 18480186 29974001 0 0 7187902 2634262 0 0 0 0 0 0 0 0 29878 15375 38649 38649 74828 1613273 1588043 0 0 0 0 0 0 270427 95480 27766641 34226665 6367343 8258013 0 0 14881 0 0 0 0 0 0 0 0 0 0 0 311245 66560 6693469 8324573 X 21073172 25902092 0 0 0 0 21073172 25902092 27766641 34226665 4842880 -13960 X false true X true false 38649 38649 0 0 0 DEFERRED RENT 51883 SECURITY DEPOSIT PAYABLE 14677 DEFERRED EXECUTIVE TRUST FUNDS 0 66560 X 72259076 -13959 772123 758164 71500912 1211474 1211474 72712386 67145162 -10677 -10677 67155839 713667 713667 67869506 FORM 990 - SCHEDULE D - PART X, LINE 2 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. FORM 990 - SCHEDULE D - RECONCILIATION OF REVENUE - PART XI The organization's separate financial statements were prepared on a statutory basis in conformity with the manual and accounting practices prescribed and permitted by the DOI (NAIC SAP). The following adjustments were required: Line 2d - Additional revenue recognized on the financial statements $772,123; $510,918 statutory audit adjustment for reversal of prior year risk adjustment; $173,908 represents a reclassification for Allowance for Doubtful Accounts which was classified as revenue on the financial statements and an balance sheet account on Form 990; <$4,449> adjustment for bonds difference in market value vs amortized cost and $91,746 represents a reclassification of rental expense to revenue. Line 4b - Additional revenue recognized on the form 990 of $1,211,474 which is Premium Deficiency Reserve (PDR) Revenue classified as revenue on the form 990 and as an expense on the financial statements, the adjustment nets to zero with the adjustment in Part XII line 4b. FORM 990 - SCHEDULE D - RECONCILIATION OF EXPENSES - PART XII The organization's separate financial statements were prepared on a statutory basis in conformity with the manual and accounting practices prescribed and permitted by the DOI (NAIC SAP). The following adjustments were required: Line 2d - Additional expenses recognized on form 990 of $10,677 represents a reclassification of expenses which were classified as revenue on the financial statements. Line 4b - Additional expenses on the financial statements of $713,667; $1,211,474 of Premium Deficiency Reserve (PDR) Revenue classified as an expense on the financial statement and as revenue on form 990, the adjustment nets to zero with the adjustment in Part XI line 4b; <$406,061> represents statutory audit adjustment to reverse a prior year adjustment relating to the IBNR over reserve and <$91,746> of rental expense re-classed to revenue. X true true true true false false false false false false false CHRISTOPHER WING DIRECTOR/CHAIRMAN 0 613351 0 426532 0 21473 0 1162962 0 18058 0 2242376 0 426532 CATHERINE BATTEER DIRECTOR/PRESIDENT 0 333662 0 112707 0 21076 0 348069 0 1801 0 817315 0 112707 WILLIAM ROTH DIRECTOR 0 440100 0 196239 0 21473 0 580675 0 34280 0 1272767 0 196239 VINOD MOHAN CHIEF FINANCIAL OFFICER 0 411018 0 129752 0 19212 0 427998 0 30687 0 1018667 0 29752 JANET KORNBLATT SECRETARY 0 317993 0 62536 0 27449 0 352195 0 12900 0 773073 0 62536 WENDY KARSTEN OUTGOING VP GENERAL MANAGER 40640 0 22243 0 117452 0 0 0 1986 0 182321 0 0 0 RICHARD PEITZMEIER VICE PRESIDENT - SALES 190994 0 32251 0 21472 0 106807 0 3210 0 354734 0 0 0 KAREN SUGANO CORPORATE VP GENERAL MANAGER 0 273839 0 75288 0 18074 0 59801 0 6827 0 433829 0 0 ANDREW WHITELOCK CHIEF RISK EXECUTIVE 0 215248 0 33277 0 18497 0 18090 0 4032 0 289144 0 0 RUSSELL BROWER CHIEF MEDICAL DIRECTOR 0 280017 0 80430 0 20667 0 106936 0 30084 0 518134 0 0 FORM 990 - SCHEDULE J - PART I, LINE 1A The Star Rating System was established by the 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 President was established and paid by a related organization. The related organization used the following to establish the Presidents compensation: 1) Compensation Committee; 2) Independent Compensation Consultant; (3) Compensation Survey or Study FORM 990 - SCHEDULE J - PART I, LINE 4A-C During 2015 the employment relationship of the following employee of SCAN Health Plan Arizona ended. In connection with the termination of her employment, SCAN Health Plan Arizona negotiated and paid severance to the employee. The severance payment was in accordance with the terms of the key employees then existing employment agreement. Wendy J Karsten, Outgoing VP General Sales - SCAN Health Plan Arizona, $111,212. FORM 990 - SCHEDULE J - PART I, LINE 4B The Company provides a supplemental non-qualified retirement plan to only 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, Catherine Batteer, William H. Roth, Janet Kornblatt and Vinod Mohan. 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. FORM 990 - PROGRAM SERVICE ACCOMPLISHMENTS - PART III, LINE 3 SCAN Health Plan Arizona elected to cease operations in Arizona- effective January 1, 2016. SCAN'S decision to exit the Arizona market followed years of financial losses, uncertainty about future revenue, and uncertainty about future sustainability and the ability to serve our members. FORM 990 - PROGRAM SERVICE ACCOMPLISHMENTS - PART III, LINE 4A SCAN Health Plan Arizona began program operations as a Medicare Advantage contractor effective January 1, 2007. It is responsible for arranging and monitoring the full range of Medicare health services for plan enrollees. The plan began offering a Medicare advantage special needs plan (SNP) for beneficiaries who were dually eligible and enrolled in both the Medicare and ALTCS programs. Beginning January 1, 2009, the Plan expanded its Medicare advantage participation to other Medicare beneficiary populations, through a Medicare advantage prescription drug (MAPD) plan. In January 2008 SCAN launched the SCAN Connections community resource center designed to link SCAN members, their caregivers and others in the Maricopa county communities with knowledgeable staff who could assist in navigating a complex health care system. The resource center staff built bridges into other community organizations, governmental agencies and health advocacy groups to provide to the community health education and support services focused on geriatric, chronic illness and physically disabled challenges. Services and resources were provided at the SCAN Connections resource center in SCANs office. SCAN Health Plan Arizona elected to cease operations in Arizona- effective January 1, 2016. FORM 990 - GOVERNANCE, MGMT & DISCLOSURE-PART VI SECTION A LINE 6 The Sole Member of the organization is SCAN Group, A California Nonprofit Public Benefit Corporation. FORM 990 -GOVERNANCE, MGMT & DISCLOSURE-PART VI SECTION A LINE 7A The sole member has the power to appoint the members of the Board of Directors. FORM 990 - POLICIES - PART VI, SECTION B, 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 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 by the Audit and Compliance Committee of the Board of Directors of SCAN Group, and is shared with all members of the Board of Directors after it is prepared, but prior to filing. FORM 990 - POLICIES - PART VI, SECTION B, LINE 12C SCAN Health Plan Arizona regularly and consistently monitored and enforced 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 the SCANs General Counsel is responsible for monitoring the Conflict of Interest questionnaire. The legal department of SCAN Group monitors and enforces adherence to these policies on an ongoing basis. FORM 990 - POLICIES - PART VI, SECTION B, LINE 15A The process for determining the compensation of the President of SCAN Health Plan Arizona is conducted by the Compensation Committee of the Board of Directors of SCAN Group, all of the voting members of which are independent persons. In determining the Presidents compensation, the 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 Compensation Committee each year which furnishes the basis for the establishment of the Presidents 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 that are considered comparable to SCAN Health Plan Arizona based on various metrics. The Compensation Committee deliberates on the issue of the Presidents compensation package in light of the Ernst & Young Executive Compensation Report and questions are asked of, and answered by, Ernst & Young, regarding such report and other matters relevant to such package. Pursuant to their deliberations, the Compensation Committee makes a recommendation to the Board of Directors of SCAN Health Plan Arizona regarding the compensation package for the following year. FORM 990 - POLICIES - PART VI, SECTION B, LINE 15B The process for determining the compensation of officers and key employees of SCAN Health Plan Arizona is conducted by the Human Resources Department and President. In determining such 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 that are considered comparable to SCAN Group based on various metrics. The President 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 such report and other matters relevant to the package. Based on such 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 - DISCLOSURE - PART VI, SECTION C, LINE 19 SCAN Health Plan Arizona's governing documents and conflict of interest policy are not made available to the public. SCAN Health Plan Arizona's audited financial statements are publicly available from the Arizona Department of Insurance for a nominal fee. FORM 990 PART IX LINE 11G DESCRIPTION:BROKER COMMISSIONS TOTAL FEES:1504115 FORM 990 PART IX LINE 11G DESCRIPTION:PHARMACY ADMIN EXPENSE TOTAL FEES:323425 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTANTS & OUTSIDE SERVICES TOTAL FEES:98382 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL EXPENSES FOR ELDERLY TOTAL FEES:62332722 SCAN GROUP 3800 KILROY AIRPORT SUITE 100 LONG BEACH CA 90806 953826037 ADMIN SUPPORT CA 501(C)(3) 11b NA false SCAN HEALTH PLAN 3800 KILROY AIRPORT SUITE 100 LONG BEACH CA 90806 953858259 MEDICARE ADVA CA 501(C)(3) 9 SCAN GROUP 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 CHECK ASSESSMENT CENTERS 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 462962358 HEALTHCARE CA NA C COPRORATION 0 0 false SCAN CALIFORNIA MANAGEMENT COMPANY 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 462951831 MANAGEMENT CA SCAN GROUP C CORPORATION 0 0 false false false false false false false false false false false false false false false true false false false SCAN Health Plan P 1222686 SG&A, SCAN HP SCAN Group P 1042170 SG&A,SCAN GROUP FORM 990 - TRANSACTIONS WITH RELATED ORGANIZATIONS - 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.