PROVIDENCE HEALTH PLAN: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- PROVIDENCE HEALTH PLAN (EIN 93-0863097)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-17
- IRS object ID
- 201403219349304060
- Schema version
- 2013v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-17T11:54:58-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 911194016 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Clark Nuber PS | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10900 NE 4th Suite 1700 | AddressLine1 |
| City | Bellevue | City |
| State | WA | State |
| ZIP Code | 98004 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930863097 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROVIDENCE HEALTH PLAN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PROV | BusinessNameControlTxt |
| Phone | 5035746330 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4400 NE Halsey Bldg 2 | AddressLine1 |
| City | Portland | City |
| State | OR | State |
| ZIP Code | 97213 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Jeffrey Butcher | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5035746330 | PhoneNum |
| Signature | 2014-11-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Sara Elizabeth J Hyre CPA | PreparerPersonNm |
| PTIN | P00235495 | PTIN |
| Phone | 4254544919 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Jack A Friedman | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4400 NE Halsey Bldg 2 | AddressLine1 |
| City | Portland | City |
| State | OR | State |
| ZIP Code | 97213 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,208,682,991 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | www.providence.org/healthplans | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1998 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | Healthcare Service Contractor. | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 17 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,100,676,071 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,128,908,490 | CYProgramServiceRevenueAmt |
| PY Investment Income | $22,713,007 | PYInvestmentIncomeAmt |
| CY Investment Income | $18,659,266 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,476,096 | PYOtherRevenueAmt |
| CY Other Revenue | $2,915,977 | CYOtherRevenueAmt |
| PY Total Revenue | $1,125,865,174 | PYTotalRevenueAmt |
| CY Total Revenue | $1,150,483,733 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $3,970,620 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $3,652,326 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $58,624,734 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $63,869,933 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,018,491,530 | PYOtherExpensesAmt |
| CY Other Expenses | $1,040,230,274 | CYOtherExpensesAmt |
| PY Total Expenses | $1,081,086,884 | PYTotalExpensesAmt |
| CY Total Expenses | $1,107,752,533 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $44,778,290 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $42,731,200 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $663,428,937 | TotalAssetsBOYAmt |
| Total Assets EOY | $720,228,488 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $159,197,886 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $171,736,215 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $504,231,051 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $548,492,273 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | As People of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.Healthcare Service Contractor. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $602,448,333 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $624,900,970 | RevenueAmt |
| Desc | Commercial group is offered to employers who provide access to health coverage to their employees. Products include Personal Option and Open Option plans. For the Individual and Family plans offered to those who are not eligible for Medicare and Medicaid, PHP served approximately 12,800 members. This product is health underwritten to manage risk appropriately with targets to reach the more than 570,000 uninsured Oregonians. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $399,591,574 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $456,854,500 | RevenueAmt |
| Desc | Providence Medicare Plans are solutions for people who are eligible for Medicare, supporting affordable access and easier administration for members. PHP advocates for evidence-based and cost effective treatments for patients and appropriate payment levels to providers to keep access to health care available to people who are eligible for Medicare. This program served approximately 44,000 members in 2013. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $35,181,366 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $48,735,824 | RevenueAmt |
| Desc | Providence offers Providence Administrative Services Only (ASO) for large groups capable of self-funding the risk experience of the group, but want claims administration and often skilled medical management; and consumer choice plans which offer qualified Health Savings Account (HSA) options. This program served approximately 191,000 members in 2013. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp (2 entries)
| ExpenseExpenseAmt | GrantGrantAmt | RevenueRevenueAmt | DescDesc |
|---|---|---|---|
| $1,158,040 | $0 | $1,166,375 | Providence Medicare Supplement plans (Medi-Gap) are no longer open plans, but we have membership that continue to be enrolled in these closed-to-new-member plans. |
| $3,652,326 | $3,652,326 | $0 | Grants & Allocations - See Schedule I. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $4,810,366 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $3,652,326 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $1,166,375 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $1,042,031,639 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | 0 | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 17 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | Yes (1) | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jeff Butcher CFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5035746390 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4400 NE Halsey Bldg 2 | AddressLine1 |
| City | Portland | City |
| State | OR | State |
| ZIP Code | 97213 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Michael Holcomb | |||||||||
| Chair of the Board | 0.10 | 8.60 | Yes (X) | Yes (X) | $0 | $60,335 | $0 | ||
| Lucille Dean SP | |||||||||
| Director | 0.10 | 9.40 | Yes (X) | $0 | $0 | $0 | |||
| Mary Corita Heid RSM | |||||||||
| Director | 0.10 | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| Michael A Stein | |||||||||
| Director | 0.10 | 6.00 | Yes (X) | $0 | $18,335 | $0 | |||
| Eugene Al Parrish | |||||||||
| Director | 0.10 | 5.00 | Yes (X) | $0 | $15,335 | $0 | |||
| Dana A Rasmussen | |||||||||
| Director | 0.10 | 4.30 | Yes (X) | $0 | $18,335 | $0 | |||
| James S Roberts MD | |||||||||
| Director | 0.10 | 9.00 | Yes (X) | $0 | $30,835 | $0 | |||
| Peter J Snow | |||||||||
| Director | 0.10 | 5.70 | Yes (X) | $0 | $20,835 | $0 | |||
| Bob Wilson | |||||||||
| Director | 0.10 | 5.00 | Yes (X) | $0 | $15,335 | $0 | |||
| Sallye Liner | |||||||||
| Director | 0.10 | 4.00 | Yes (X) | $0 | $15,335 | $0 | |||
| Cheryl M Scott | |||||||||
| Director | 0.10 | 4.60 | Yes (X) | $0 | $15,335 | $0 | |||
| Ellen L Wolf | |||||||||
| Director | 0.10 | 7.10 | Yes (X) | $0 | $15,335 | $0 | |||
| Isiaah Crawford | |||||||||
| Director | 0.10 | 4.10 | Yes (X) | $0 | $15,335 | $0 | |||
| Martha Diaz Aszkenazy | |||||||||
| Director | 0.10 | 7.70 | Yes (X) | $0 | $15,335 | $0 | |||
| Kirby McDonald | |||||||||
| Director | 0.10 | 4.60 | Yes (X) | $0 | $15,335 | $0 | |||
| Dave Olsen | |||||||||
| Director | 0.10 | 5.50 | Yes (X) | $0 | $15,335 | $0 | |||
| Charles Chuck Watts | |||||||||
| Director | 0.10 | 4.60 | Yes (X) | $0 | $15,335 | $0 | |||
| Jeffrey W Rogers - Thru 513 | |||||||||
| Corporate Secretary | 0.10 | 49.90 | Yes (X) | $0 | $1,040,781 | $189,880 | |||
| Cindy Strauss - Eff 613 | |||||||||
| SVP/Chief Counsel/Corp. Secretary | 0.10 | 59.90 | Yes (X) | $0 | $955,824 | $248,254 | |||
| Jack Friedman | |||||||||
| SVP/Account Care & Payor Rel. | 1.00 | 54.00 | Yes (X) | $0 | $826,281 | $177,752 | |||
| Alison S Schrupp | |||||||||
| CSO | 19.00 | 36.00 | Yes (X) | $0 | $487,934 | $106,585 | |||
| Barbara L Christensen | |||||||||
| Chief Sales & Mkt. Officer | 15.00 | 30.00 | Yes (X) | $0 | $355,146 | $76,433 | |||
| Michael G White | |||||||||
| COO | 17.00 | 33.00 | Yes (X) | $0 | $378,050 | $86,302 | |||
| Bruce W Wilkinson | |||||||||
| CIO | 15.00 | 30.00 | Yes (X) | $0 | $384,006 | $102,103 | |||
| Robert A Gluckman | |||||||||
| CMO | 17.00 | 33.00 | Yes (X) | $0 | $431,702 | $144,340 | |||
| Jeffrey Butcher | |||||||||
| CFO | 17.00 | 33.00 | Yes (X) | $0 | $285,033 | $39,452 | |||
| Greg Van Pelt - Thru 413 | |||||||||
| SVP/CEO - OR. Region | 1.00 | 59.00 | $0 | $1,370,941 | $383,928 | Yes (X) | |||
| Dave Underriner - Eff 413 | |||||||||
| SVP/CEO - OR. Region | 1.00 | 59.00 | $0 | $2,910,696 | $106,590 | Yes (X) | |||
| Shelly M Handkins - Thru 413 | |||||||||
| CFO/OR. Region | 1.00 | 49.00 | $0 | $502,246 | $368,641 | Yes (X) | |||
| William Olson - Eff 413 | |||||||||
| CFO/OR. Region | 1.00 | 49.00 | $0 | $582,354 | $125,398 | Yes (X) | |||
| James H Mackay | |||||||||
| Medical Director | 17.00 | 33.00 | $0 | $306,324 | $85,766 | Yes (X) | |||
| Carrie Smith | |||||||||
| Chief Compliance Officer | 17.00 | 33.00 | $0 | $212,994 | $38,144 | Yes (X) | |||
| Stephanie C Dreyfuss | |||||||||
| Dir. Network Develop. | 14.00 | 26.00 | $0 | $261,560 | $29,418 | Yes (X) | |||
| Susan Abate | |||||||||
| Dir. Quality Med. Mgr. | 14.00 | 26.00 | $0 | $212,592 | $81,105 | Yes (X) | |||
| Katherine L Powell | |||||||||
| Chief Innovation Officer | 17.00 | 33.00 | $0 | $254,473 | $34,753 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $12,060,962 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,424,844 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PH&S-OR dba Prov Portland Medical Cente | |||||
| PO BOX 3395 | Portland | OR | 97208 | Hospital and Healthcare Services | $126,250,665 |
| PH&S-OR dba Prov St Vincent Medical Ce | |||||
| PO BOX 13993 | Portland | OR | 97208 | Hospital and Healthcare Services | $119,080,075 |
| Salem Hospital | |||||
| 890 Oak Street SE | Salem | OR | 97301 | Hospital and Healthcare Services | $62,567,380 |
| PH&S-OR dba Prov Medical Group - North | |||||
| PO BOX 3158 | Portland | OR | 97208 | Physician Services | $55,710,930 |
| Oregon Health Sciences University | |||||
| PO BOX 575 | Portland | OR | 97207 | Healthcare | $53,453,039 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 953 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| EPO Premiums | 900099 | $623,478,644 | $623,478,644 |
| Medicare Payments | 900099 | $455,658,307 | $455,658,307 |
| ASO Fees | 900099 | $48,608,218 | $48,608,218 |
| Medicare Supp. Premium | 900099 | $1,163,321 | $1,163,321 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,128,908,490 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,073,623 | TotalRevenueColumnAmt |
| Exclusion | $17,073,623 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $5,567,308 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $5,455,986 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $111,322 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $111,322 | TotalRevenueColumnAmt |
| Exclusion | $111,322 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,054,292,515 | SecuritiesAmt |
| Other | $36,400 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,052,743,272 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,549,243 | SecuritiesAmt |
| Other | $36,400 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,585,643 | TotalRevenueColumnAmt |
| Exclusion | $1,585,643 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| ACO Reimbursement | 900099 | $2,488,606 | $2,488,606 |
| Capital Usage Fee | 900099 | $128,800 | $128,800 |
| Retiree Reimbursement | 900099 | $98,500 | $98,500 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $88,749 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $33,273 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $55,476 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,804,655 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,150,483,733 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,131,657,669 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $18,826,064 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,652,326 | TotalAmt |
| Program Services | $3,652,326 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,783,945 | TotalAmt |
| Program Services | $555,827 | ProgramServicesAmt |
| Management And General | $2,228,118 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,280,356 | TotalAmt |
| Program Services | $31,134,189 | ProgramServicesAmt |
| Management And General | $12,146,167 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,805,632 | TotalAmt |
| Program Services | $11,571,958 | ProgramServicesAmt |
| Management And General | $6,233,674 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $788,375 | TotalAmt |
| Program Services | $579,252 | ProgramServicesAmt |
| Management And General | $209,123 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,132,593 | TotalAmt |
| Management And General | $1,132,593 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,466,719 | TotalAmt |
| Program Services | $8,730,790 | ProgramServicesAmt |
| Management And General | $7,735,929 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $417,171 | TotalAmt |
| Program Services | $417,171 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,088,186 | TotalAmt |
| Program Services | $1,675,605 | ProgramServicesAmt |
| Management And General | $1,412,581 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,044,242 | TotalAmt |
| Program Services | $4,353,033 | ProgramServicesAmt |
| Management And General | $2,691,209 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,148,173 | TotalAmt |
| Program Services | $3,086,579 | ProgramServicesAmt |
| Management And General | $1,061,594 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $661,004 | TotalAmt |
| Program Services | $197,054 | ProgramServicesAmt |
| Management And General | $463,950 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,587 | TotalAmt |
| Program Services | $46,202 | ProgramServicesAmt |
| Management And General | $47,385 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,584,375 | TotalAmt |
| Program Services | $5,472,565 | ProgramServicesAmt |
| Management And General | $10,111,810 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,314,285 | TotalAmt |
| Program Services | $881,821 | ProgramServicesAmt |
| Management And General | $432,464 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,809 | TotalAmt |
| Program Services | $31,110 | ProgramServicesAmt |
| Management And General | $10,699 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Claims | $961,794,206 | $961,794,206 | |
| Commission Fees | $14,029,093 | $14,029,093 | |
| OR & WA High Risk Pool | $6,937,709 | $3,815,740 | $3,121,969 |
| Premium Tax | $4,474,041 | $2,460,722 | $2,013,319 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,214,706 | TotalAmt |
| Program Services | $1,575,489 | ProgramServicesAmt |
| Management And General | $639,217 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,107,752,533 | TotalAmt |
| Program Services | $1,042,031,639 | ProgramServicesAmt |
| Management And General | $65,720,894 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,392,145 | BOYAmt |
| EOY | $36,487,646 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,868,812 | BOYAmt |
| EOY | $2,176,572 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $95,700 | BOYAmt |
| EOY | $105,270 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $103,534,018 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $28,374,723 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $77,261,801 | BOYAmt |
| EOY | $75,159,295 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $522,960,821 | BOYAmt |
| EOY | $557,896,199 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,399,526 | BOYAmt |
| EOY | $10,084,533 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,450,132 | BOYAmt |
| EOY | $38,318,973 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $663,428,937 | BOYAmt |
| EOY | $720,228,488 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,338,891 | BOYAmt |
| EOY | $1,670,102 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,420,166 | BOYAmt |
| EOY | $11,188,002 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $143,438,829 | BOYAmt |
| EOY | $158,878,111 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $159,197,886 | BOYAmt |
| EOY | $171,736,215 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,716,441 | BOYAmt |
| EOY | $73,716,441 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $430,514,610 | BOYAmt |
| EOY | $474,775,832 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $504,231,051 | BOYAmt |
| EOY | $548,492,273 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $663,428,937 | BOYAmt |
| EOY | $720,228,488 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $42,731,200 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,530,023 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$1 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $79,730,868 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,148,296 | DepreciationAmt |
| Book Value | $67,582,572 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,663,422 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,866,658 | DepreciationAmt |
| Book Value | $2,796,764 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,791,976 | OtherCostOrOtherBasisAmt |
| Depreciation | $14,359,769 | DepreciationAmt |
| Book Value | $2,432,207 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,347,752 | OtherCostOrOtherBasisAmt |
| Book Value | $2,347,752 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $75,159,295 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (12 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Pharmacy Rebate Receivable | $3,139,919 |
| Receivable from ASO Clients | $1,806,659 |
| Due from Affiliates | $1,035,296 |
| Investment Income Accruals | $3,184,991 |
| Due from CMS | $8,719,778 |
| Land Trustee Funds | $15,791,140 |
| Alternate Funding Arrangement | $1,167,805 |
| Reinsurance Receivable | $619,144 |
| Overpayment recoveries outstanding | $295,723 |
| Receivable from State of Oregon - Children's Reinsurance Pool | $1,983,554 |
| Provider Receivable | $552,964 |
| Pass-Thru Receivable - Due from Portland General Electric | $22,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $38,318,973 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (12 entries)
| DescDesc | AmtAmt |
|---|---|
| Unpaid Claims & Withholdings | $108,891,964 |
| Due to Affiliates | $11,446,093 |
| Due to Medicare Part D | $9,547,818 |
| Miscellaneous Payables | $1,641,659 |
| Deposits Insured Grp. Alternative Arrangements | $4,267,238 |
| Claim Refunds in Process | $1,573,907 |
| Pre-funding of ASO Claims | $5,482,301 |
| ASO Client Health Improvement Fund | $786,288 |
| Premium deficiency reserve | $10,565,234 |
| Unpaid Claims Liability for Administrative expenses | $2,568,464 |
| Broker commission accrual | $471,103 |
| ASO Rx Rebates and Refunds | $1,636,042 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $158,878,111 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $1,097,021,404 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $1,530,023 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$2,625,004 | OtherRevenueAmt |
| Revenue Not Reported | -$1,094,981 | RevenueNotReportedAmt |
| Revenue Subtotal | $1,098,116,385 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $1,132,593 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $51,234,755 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $52,367,348 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $1,150,483,733 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,048,285,377 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | -$4,108,939 | OtherExpensesIncludedAmt |
| Expenses Not Reported | -$4,108,939 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,052,394,316 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $1,132,593 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $54,225,624 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $55,358,217 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $1,107,752,533 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part X, Line 2: | The Plan's management evaluates tax positions taken by the Plan and recognize a tax liability if the Plan has taken an uncertain position that more likely than not would not be sustained upon examination by the IRS. Management has analyzed tax positions taken by the Plan and concluded that as of December 31, 2013, there are no uncertain positions taken or expected to be taken that would require recognition of a liability or disclosure in the financial statements. |
| Part XI, Line 2d - Other Adjustments: | Ceded - Reinsurance Premiums -4,667,986. Gross-up Medicare Part D Reserve 559,047. Accrual of Straight-line Lease amount 1,483,935. |
| Part XI, Line 4b - Other Adjustments: | Capital Usage Fee from PPP & PHA 128,800. ASO Fees 48,608,218. Reimbursement for Accountable Care expenses 2,488,606. Rounding -1. Investment Income Adjustment 9,132. |
| Part XII, Line 2d - Other Adjustments: | Ceded Reinsurance Premiums -4,667,986. Gross-up Medicare Part D Reserve 559,047. |
| Part XII, Line 4b - Other Adjustments: | Capital Usage Fee 128,800. Reimbursement for Accountable expenses 2,488,606. ASO Fees 48,608,218. Affiliate Transfer 3,000,000. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (31 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| Providence Portland Medical Foundation | |||||||
| 4805 NE Glisan Street | Portland | OR | 97213 | 931231494 | 501(c)(3) | $3,140,000 | Assistance with medical bills for the needy & Operations |
| Oregon Public Heath Institute (OPHI) | |||||||
| 315 SW Fifth Avenue | Portland | OR | 97204 | 931259522 | 501(c)(3) | $50,000 | Support Oregonians who are in health crises and educate community partners to realize health improvement and equity. Community Building. |
| Stand For Children | |||||||
| 1732 NW Quimby Street Ste 200 | Portland | OR | 97209 | 521957214 | 501(c)(3) | $35,000 | Improving educational opportunities to students of the Portland Public Schools |
| Helping Hands Christian Community Outreach | |||||||
| 1530 S Roosevelt Drive | Seaside | OR | 97138 | 271158468 | 501(c)(3) | $25,000 | Helping Hands Reentry Program |
| Janus Youth Programs Inc | |||||||
| 707 NE Couch Street | Portland | OR | 97232 | 237345990 | 501(c)(3) | $25,000 | Building Health Equity for Diverse Communities |
| Outgrowing Hunger | |||||||
| 235 NE 56th Avenue | Portland | OR | 97213 | 452380984 | 501(c)(3) | $25,000 | Social Determinants of Health: Meeting Basic Needs for Healthy Outcomes |
| Saint Andre Bessette Catholic Church | |||||||
| 601 W Burnside Street | Portland | OR | 97209 | 930391635 | 501(c)(3) | $25,000 | Social Determinants of Health: Meeting Basic Needs for Healthy Outcomes |
| The Wallace Medical Concern | |||||||
| 124 NE 181st Street Suite 103 | Portland | OR | 97230 | 930853709 | 501(c)(3) | $25,000 | Building Health Equity for Diverse Communities |
| Transition Projects | |||||||
| 665 NW Hoyt Street | Portland | OR | 97209 | 930591582 | 501(c)(3) | $25,000 | Social Determinants of Health: Meeting Basic Needs for Healthy Outcomes |
| JOIN | |||||||
| 1435 NE 81st Avenue | Portland | OR | 97213 | 931090005 | 501(c)(3) | $23,750 | Social Determinants of Health: Meeting Basic Needs for Healthy Outcomes |
| SW Community Health Center | |||||||
| 7754 SW Capitol Highway | Portland | OR | 97219 | 743050497 | 501(c)(3) | $20,160 | Building Health Equity for Diverse Communities |
| Oregon Food Bank | |||||||
| PO Box 55370 | Portland | OR | 97238 | 930785786 | 501(c)(3) | $15,336 | Essential Services - Stop Hunger Campaign |
| Rose Haven | |||||||
| 627 NW 18th Ave | Portland | OR | 97211 | 205922682 | 501(c)(3) | $15,000 | Advocacy Services for the women at Rose Haven. |
| St Vincent de Paul of Lane County | |||||||
| 2890 Chad Drive | Eugene | OR | 97402 | 930454786 | 501(c)(3) | $15,000 | Suppport Emergency Housing |
| Jasper Mountain | |||||||
| 37875 Jasper-Lowell Road | Jasper | OR | 97438 | 930855920 | 501(c)(3) | $13,152 | Serve the needy families and children who are mentally and chronically ill. |
| Tucker Arnold Foundation | |||||||
| 7155 SW Sagert St 109 | Tualatin | OR | 97062 | 452067281 | 501(c)(3) | $13,152 | Serve the needy children who are chronically ill. |
| St Vincent de Paul | |||||||
| PO Box 42157 | Portland | OR | 97242 | 930831082 | 501(c)(3) | $12,957 | Support of mobile food van, rental assistance, heat/utilities for those in ER need. |
| Boys and Girls Club of Rogue Valley | |||||||
| 203 SE 9th Street | Grants Pass | OR | 97526 | 930588108 | 501(c)(3) | $10,000 | Access to Preventative Care |
| Cascadia Behavioral Health | |||||||
| 847 NE 19th Avenue Suite 100 | Portland | OR | 97207 | 930770054 | 501(c)(3) | $10,000 | Basic Needs - homeless services, client assistance and earmarked for area of greatest need. |
| Catholic Charities | |||||||
| 2740 SE Powell Blvd | Portland | OR | 97202 | 930386801 | 501(c)(3) | $10,000 | Basic Needs - help people with housing, food, rent, transportation to medical appointments and assistance with prescriptions; ER assistance. |
| Central City Concern | |||||||
| 232 NW Sixth Avenue | Portland | OR | 97209 | 930728816 | 501(c)(3) | $10,000 | Behavioral Health - 2013 Homeless Action Fund |
| Jewish Family and Child Services | |||||||
| 1221 SW Yamhill Street 301 | Portland | OR | 97205 | 930386851 | 501(c)(3) | $10,000 | Providing emergency financial assistance including food, housing, utilities, medical bills, clothing, medications, transportation and other life-sustaining needs. |
| Love Inc of Clackamas | |||||||
| 209 S Main Street | Newberg | OR | 97132 | 260068805 | 501(c)(3) | $10,000 | Basic Needs - providing a coordinated network of care and help to the poor; practical good and services, meeting unmet ER needs of the poor. |
| Lutheran Community Multicultural Services | |||||||
| 605 SE 37th Avenue | Portland | OR | 97214 | 930386860 | 501(c)(3) | $10,000 | Basic Needs-Diverse Populations - ER housing, rental assistance, household goods, food; specifically for refugee resettlement needs. |
| Macdonald Center | |||||||
| 121 NW Sixth Avenue | Portland | OR | 97209 | 931060938 | 501(c)(3) | $10,000 | Basic Needs - Outreach, support services and medication management to the 'forgotten poor' of Portland/Old Town, Drop-in Center. |
| Meals on Wheels | |||||||
| 7710 SW 31st Avenue | Portland | OR | 97219 | 930584318 | 501(c)(3) | $10,000 | Basic Needs delivering nutritious meals and proving needed services to older adults, persons with disabilities and other homebound person who might suffer from social isolation. |
| Medical Teams International Mobile Dental | |||||||
| PO Box 10 | Portland | OR | 97207 | 930878944 | 501(c)(3) | $10,000 | Oral Health Care - funding to be used toward one of the dental vans in rural or impoverished area of Oregon; providing free or low-cost dental care to low income children and adults. |
| Neighbor Impact | |||||||
| 2303 SW 1st Street | Redmond | OR | 97756 | 930884929 | 501(c)(3) | $10,000 | Serving the poor and vulnerable of Central OR. |
| Social Services of Clackamas County | |||||||
| 2051 Kaen Rd | Oregon City | OR | 97045 | 943032590 | 501(c)(3) | $10,000 | Basic Needs - helping people with short term assistance for prescriptions, identification cards, gas vouchers and work uniforms. |
| Urban Gleaners | |||||||
| 430 NW 5th Avenue | Portland | OR | 97209 | 204641665 | 501(c)(3) | $10,000 | Basic Needs - Providing homeless families the opportunity to receive nourishment. |
| Metropolitan Family Services | |||||||
| 1808 SE Belmont Street | Portland | OR | 97214 | 930397825 | 501(c)(3) | $7,000 | Behavioral Health - helping people move beyond limitation of poverty, inequity and social isolation. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 31 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | We request and condition grants upon each of the following: 1) The program summary and budget; 2) Verification of malpractice and liability coverage; 3) Updates provided every six months; 4) Documentation evidencing tax-exempt or municipal status; 5) Documentation showing that they serve the low income and uninsured regardless of ability to pay for services; 6) Provide upon request, financial reporting of the budgeted use of grant funds. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Jeffrey W Rogers - Thru 513 | ||||||||||||||
| Corporate Secretary | $0 | $442,462 | $0 | $529,200 | $0 | $69,119 | $0 | $168,789 | $0 | $21,091 | $0 | $1,230,661 | $0 | $0 |
| Cindy Strauss - Eff 613 | ||||||||||||||
| SVP/Chief Counsel/Corp. Secretary | $0 | $413,323 | $0 | $525,001 | $0 | $17,500 | $0 | $223,587 | $0 | $24,667 | $0 | $1,204,078 | $0 | $0 |
| Jack Friedman | ||||||||||||||
| SVP/Account Care & Payor Rel. | $0 | $508,016 | $0 | $300,765 | $0 | $17,500 | $0 | $151,382 | $0 | $26,370 | $0 | $1,004,033 | $0 | $0 |
| Alison S Schrupp | ||||||||||||||
| CSO | $0 | $318,573 | $0 | $155,745 | $0 | $13,616 | $0 | $86,463 | $0 | $20,122 | $0 | $594,519 | $0 | $0 |
| Barbara L Christensen | ||||||||||||||
| Chief Sales & Mkt. Officer | $0 | $268,116 | $0 | $56,567 | $0 | $30,463 | $0 | $56,391 | $0 | $20,042 | $0 | $431,579 | $0 | $0 |
| Michael G White | ||||||||||||||
| COO | $0 | $308,739 | $0 | $51,811 | $0 | $17,500 | $0 | $80,350 | $0 | $5,952 | $0 | $464,352 | $0 | $0 |
| Bruce W Wilkinson | ||||||||||||||
| CIO | $0 | $231,878 | $0 | $134,628 | $0 | $17,500 | $0 | $83,215 | $0 | $18,888 | $0 | $486,109 | $0 | $0 |
| Robert A Gluckman | ||||||||||||||
| CMO | $0 | $378,905 | $0 | $52,797 | $0 | $0 | $0 | $124,125 | $0 | $20,215 | $0 | $576,042 | $0 | $0 |
| Jeffrey Butcher | ||||||||||||||
| CFO | $0 | $247,703 | $0 | $37,330 | $0 | $0 | $0 | $20,530 | $0 | $18,922 | $0 | $324,485 | $0 | $0 |
| Greg Van Pelt - Thru 413 | ||||||||||||||
| SVP/CEO - OR. Region | $0 | $397,517 | $0 | $537,371 | $0 | $436,053 | $0 | $367,609 | $0 | $16,319 | $0 | $1,754,869 | $0 | $0 |
| Dave Underriner - Eff 413 | ||||||||||||||
| SVP/CEO - OR. Region | $0 | $558,191 | $0 | $2,335,005 | $0 | $17,500 | $0 | $80,853 | $0 | $25,737 | $0 | $3,017,286 | $0 | $580,372 |
| Shelly M Handkins - Thru 413 | ||||||||||||||
| CFO/OR. Region | $0 | $393,634 | $0 | $108,612 | $0 | $0 | $0 | $345,190 | $0 | $23,451 | $0 | $870,887 | $0 | $0 |
| William Olson - Eff 413 | ||||||||||||||
| CFO/OR. Region | $0 | $289,334 | $0 | $293,020 | $0 | $0 | $0 | $104,559 | $0 | $20,839 | $0 | $707,752 | $0 | $0 |
| James H Mackay | ||||||||||||||
| Medical Director | $0 | $288,413 | $0 | $17,911 | $0 | $0 | $0 | $67,253 | $0 | $18,513 | $0 | $392,090 | $0 | $0 |
| Carrie Smith | ||||||||||||||
| Chief Compliance Officer | $0 | $187,424 | $0 | $25,570 | $0 | $0 | $0 | $19,762 | $0 | $18,382 | $0 | $251,138 | $0 | $0 |
| Stephanie C Dreyfuss | ||||||||||||||
| Dir. Network Develop. | $0 | $211,456 | $0 | $34,220 | $0 | $15,884 | $0 | $10,815 | $0 | $18,603 | $0 | $290,978 | $0 | $0 |
| Susan Abate | ||||||||||||||
| Dir. Quality Med. Mgr. | $0 | $192,062 | $0 | $20,530 | $0 | $0 | $0 | $62,750 | $0 | $18,355 | $0 | $293,697 | $0 | $0 |
| Katherine L Powell | ||||||||||||||
| Chief Innovation Officer | $0 | $221,837 | $0 | $32,620 | $0 | $16 | $0 | $15,792 | $0 | $18,961 | $0 | $289,226 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Lines 4a-b | NONQUALIFIED RETIREMENT PLANS A) SERP = Supplemental Executive Retirement Plan B) CBRP = Cash Balance Restoration Plan C) ESP = Elective Survivor Plan 1) Jeffrey W. Rogers a) Taxable SERP Earned but not Paid - $44,111 b) SERP Interest Credit- $97,420 c) ESP Interest Credit - $7,567 2) Cindy Strauss a) SERP Earned but not Vested - $190,313 b) SERP Interest Credit - $14,149 3) Jack Friedman a) Taxable SERP Earned but not Paid - $54,169 b) SERP Interest Credit - $100,470 4) Alison S. Schrupp a) SERP Interest Credit - $55,128 b) Taxable SERP Earned but Not Paid - $106,423 c) Taxable CBRP Earned but Not Paid - $1,656 d) ESP Interest Credit - $3,273 5) Barbara L. Christensen a) SERP Interest Credit - $5,276 b) Taxable SERP Earned but Not Paid - $16,237 c) ESP Interest Credit - $2,932 6) Michael G. White a) SERP Interest Credit - $2,741 b) SERP Earned but Not Vested - $52,954 7) Bruce W. Wilkinson a) SERP Interest Credit - $55,949 b) Taxable SERP Earned but Not Paid - $97,368 c) Taxable CBRP Earned but Not Paid - $50 8) Robert A. Gluckman a) SERP Interest Credit - $22,366 b) SERP Earned but not Vested - $69,788 c) Taxable CBRP - $138 9) Jeff Butcher a) SERP Earned but Not Vested - $8,603 b) SERP Interest Credit - $988 10) Greg VanPelt a) Interest Credit - $22,874 b) Taxable SERP Earned but Not Paid - $123,019 c) Non-taxable SERP Earned but Not Paid - $294,235 11) David T. Underriner a) SERP Interest Credit - $22,874 b) Taxable SERP Earned but Not Paid - $2,199,418 c) ESP Interest Credit - $2,998 12) Shelly M. Handkins a) SERP Interest Credit - $92,880 b) SERP Earned but Not Vested - $217,913 13) William Olson a) SERP Interest Credit - $12,401 b) SERP Earned but Not Vested - $56,756 c) Taxable CBRP Earned but Not Paid - $4 d) Taxable SERP Earned but Not Paid - $220,167 14) James H. Mackay a) Taxable CBRP Earned but Not Paid - $9,359 b) Non-Taxable CBRP Earned but Not Paid - $1,311 |
| Part I, Lines 4a-b | Severance Greg VanPelt - $367,890 |
| FORM 990, SCHEDULE J, PART II - EXECUTIVE PERFORMANCE AWARDS PROGRAM | The Providence Executive Incentive Program provides a lump sum award annually as a percent of the executive's base pay. Percent opportunities are aligned with our total compensation philosophy as outlined in Part VI, Section B, Line 15 (Process for determining compensation of top management, officers & key employees). The performance award is based on the level of accomplishment of annual system objectives and personal objectives. In 2013, 50 percent of the participant awards were based on pre-determined organizational goals consistent with Providence's five strategic priorities of: mission driven, financially responsible, people centered, service oriented and EPIC watchlist. In 2013 the percent allocation for each of these strategic priorities was: Mission driven 5% Financially responsible 15% People centered 10% Service oriented 10% EPIC Watchlist 10% To ensure affordability of the program, the organization (system, region or entity) must meet a threshold of 50 percent of budgeted net operating income. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | The sole Corporate Member is Providence Plan Partners. |
| Form 990, Part VI, Section A, line 7a | The powers of the Corporate Member include the provision to appoint the number of Directors, appoint the Board of Directors and to remove such Directors at any time with or without cause. |
| Form 990, Part VI, Section A, line 7b | The following powers reside with the Member: * To adopt or change the mission, philosophy, and values of the Corporation. * To amend or repeal the Articles of Incorporation and the Bylaws of the Corporation. * To approve the acquisition of assets, the incurrence of indebtedness or the lease, sale, transfer, assignment or encumbering of the assets, in excess of a specified amount. * To approve the dissolution and/or liquidation or the consolidation or merger of the Corporation. * To approve the annual operating and capital budget and approval any deviations from the budget exceeding a specified amount. * To appoint the Corporation's certified public accountants after receiving recommendation of the Board of Directors. * To approve the lending of Corporate funds, other than the purchase of publicly traded securities, to unaffiliated organizations. * To approve the closure of any institution or major ministry or work within this Corporation. |
| Form 990, Part VI, Section B, line 11 | The Form 990 is prepared internally by experienced staff and reviewed by the internal Director of Taxes and external tax advisors. The Board of Directors reviewed the Form 990 prior to filing with the IRS. |
| Form 990, Part VI, Section B, line 12c | Providence Health & Services maintains a conflict of interest policy that applies to board members and management of all Providence-related organizations. The purpose of the policy is to guide and direct those serving the Providence Health & Services' corporations and other legal entities so they can (1) fulfill their fiduciary responsibilities and exercise stewardship in ways that promote and protect the best interests of Providence and, (2) avoid situations that create a conflict, or the appearance of a conflict, between the interests of an individual associated with Providence and Providence. On an annual basis, each board member and management level employee must complete and submit an updated conflict of interest statement. Conflict of interest disclosures are reviewed by the System Integrity Department working in conjunction with the Department of Legal Affairs. If it is determined that an actual conflict exists, appropriate follow-up action is taken with the individual to rectify the conflict. |
| Form 990, Part VI, Section B, line 15 | It is Providence's intention to make financial information accessible and transparent. Although the filing of Form 990 provides insight into how Providence achieves its Mission, delivers its programs and stewards its finances, deciphering the information directly from Form 990 can be challenging. The following paragraphs provide further information about the process we use to determine compensation for top management, officers and key employees. Providence has a single fiduciary Board, with responsibility for financial oversight associated with fulfillment of the Providence Mission, developing system policies, protecting the assets entrusted to the organization and overseeing the strategic and operational affairs of Providence's legal entities. Providence also maintains a network of community ministry boards with responsibility for quality of care oversight, community relations, advocacy and community needs assessments. Providence has a consistent compensation philosophy for all of its employees, including our senior executives. Salaries for senior executives are determined by the Providence Board's Human Resources Committee and approved by the full Board of Directors, none of whom is a Providence employee. The Board retains an independent consultant each year to review salaries of those in the most significant leadership roles in the organization. Part of the consultant's role is to review an extensive array of compensation surveys of large, not-for-profit health care systems in the United States. Providence is one of the larger health systems in the country, and as such, the Board benchmarks executive compensation against other large, not-for-profit health systems whose revenue is similar to that of Providence. Base salaries for Providence executives are set at the median level of the market, as identified by the independent consultant and reviewed with the Human Resources Committee. Performance incentives allow executives to earn additional compensation if they achieve specific organizational and individual goals for furthering Providence operating principles - advancing the Providence Mission and core values, meeting benchmarks for charity care, achieving quality targets, delivering top-rated customer satisfaction, meeting employee satisfaction goals and reaching financial performance objectives. The Board of Directors conducts a thorough process to ensure performance incentives are aligned with appropriate practices for not-for-profit health care systems. The Board's process for executive compensation fully complies with IRS standards and mirrors the best practices recommended in the "Report to Congress and the Nonprofit Sector on Governance, Transparency, and Accountability" submitted to the Senate Finance Committee by the Panel on the Nonprofit Sector. |
| Form 990, Part VI, Section C, line 19 | Public disclosure of governing documents, conflict of interest policy and 990 filings are made available to the public upon written request. The consolidated financial statements are available on our public Internet site www2.providence.org. All governing policies including the conflict of interest policy, as well as 990 filings are available to employees on the Intranet site. |
| Form 990, Part VII | Michael Holcomb - 1801 Lind Avenue SW, #9016, Renton, WA 98057. Lucille Dean, SP - 1801 Lind Avenue SW, #9016, Renton, WA 98057. Mary Corita Heid, RSM - 1801 Lind Avenue SW, #9016, Renton, WA 98057. Michael A. Stein - 1801 Lind Avenue SW, #9016, Renton, WA 98057. Eugene "Al" Parrish - 1801 Lind Avenue SW, #9016, Renton, WA 98057. Dana A. Rasmussen - 1801 Lind Avenue SW, #9016, Renton, WA 98057. James S. Roberts, MD - 1801 Lind Avenue SW, #9016, Renton, WA 98057. Peter J. Snow - 1801 Lind Avenue SW, #9016, Renton, WA 98057. Bob Wilson - 1801 Lind Avenue SW, #9016, Renton, WA 98057. Sallye Liner - 1801 Lind Avenue SW, #9016, Renton, WA 98057. Cheryl M. Scott - 1801 Lind Avenue SW, #9016, Renton, WA 98057. Ellen L. Wolf - 1801 Lind Avenue SW, #9016, Renton, WA 98057. Isiaah Crawford - 1801 Lind Avenue SW, #9016, Renton, WA 98057. Martha Diaz Aszkenazy - 1801 Lind Avenue SW, #9016, Renton, WA 98057. Kirby McDonald - 1801 Lind Avenue SW, #9016, Renton, WA 98057. Dave Olsen - 1801 Lind Avenue SW, #9016, Renton, WA 98057. Charles (Chuck) Watts - 1801 Lind Avenue SW, #9016, Renton, WA 98057. Jeffrey W. Rogers - Thru 5/13 - 1801 Lind Avenue SW, #9016, Renton, WA 98057. Cindy Strauss - Eff 6/13 - 1801 Lind Avenue SW, #9016, Renton, WA 98057. |
| Form 990, Part XI, line 9: | Rounding -1. |
| FORM 990, PART XII, LINE 2C - AUDIT & COMPLIANCE | The Providence Health & Services Audit and Compliance Committee assists the Board of Directors with the oversight of the integrity of the financial statements and reporting, the audit process and the internal financial controls and policies; compliance with ethical, legal and regulatory standards and requirements; the independence, qualifications and performance of the internal and external auditors; the investment committee; and informs the Board of Directors of critical risk areas and recommended mitigation. |
| FORM 990, PART IV, LINE 12 - AUDITED FINANCIAL STATEMENTS | The audited financial statements of Providence Health Plan are prepared on a statutory basis in conformity with insurance accounting practices prescribed or permitted by the National Association of Insurance Commissioners and the Insurance Division of the Oregon Department of Consumer and Business Services. |
| FORM 990, PART II, LINE 5 & PART V, LINE 2A - EMPLOYEE COMPENSATION | The employees working at Providence Health Plan are paid by Providence Health & Services - Oregon EIN# 51-0216587 or Providence Health & Services - WA. dba Health System Office EIN# 91-0725998. Therefore, no W-2s are issued by the reporting organization. |
| FORM 990, PART VII - RELIGIOUS COMMUNITY MEMBERS | As members of the Religious Community, each Sister has taken a vow of poverty as a compulsory part of her religious life. Any compensation for services of a Sister inures only for the benefit of the Community, not the individual members. All payments for services are made directly to the Religious Community. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (65 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Providence Health & Services - Washington | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 510216586 | Healthcare System | WA | 501( c)(3) | Line 3 | Providence Health & Services | 0 | |
| Providence Health & Services - Oregon | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 510216587 | Healthcare System | OR | 501( c)(3) | Line 3 | Providence Health & Services | 0 | |
| Providence Health System - So California | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 510216589 | Healthcare System | CA | 501( c)(3) | Line 3 | Providence Health & Services | 0 | |
| Everett Transitional Care Services | |||||||||||
| PO Box 5128 | Everett | WA | 982065128 | 943264605 | Transitional Care | WA | 501( c)(3) | Line 9 | 0 | N/A | |
| Providence Oregon Management Corporation | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 930813977 | Shell Corporation | OR | 501( c)(3) | Line 1 | PH & S - Oregon | 0 | |
| Providence Plan Partners | |||||||||||
| 4400 NE Halsey Bldg 2 | Portland | OR | 97213 | 911861964 | Healthcare Services | OR | 501( c)(4) | N/A | PH & S - Oregon | 0 | |
| Providence Health Assurance | |||||||||||
| 4400 NE Halsey Bldg 2 | Portland | OR | 97213 | 550828701 | Medicaid Healthcare Provider | OR | 501( c)(4) | N/A | Providence Health Plan | Yes (1) | |
| Providence Medical Institute | |||||||||||
| 4101 Torrance Blvd | Torrance | CA | 90503 | 330283773 | Healthcare | CA | 501( c)(3) | Line 11/Type I | PHS - So California | 0 | |
| Little Company of Mary Ancillary Services Corporation | |||||||||||
| 4101 Torrance Blvd | Torrance | CA | 90503 | 330844408 | Imaging Services | CA | 501( c)(3) | Line 9 | PHS - So California | 0 | |
| Providence TrinityCare Hospice | |||||||||||
| 5315 Torrance Blvd Suite B1 | Torrance | CA | 90503 | 953264139 | Hospice | CA | 501( c)(3) | Line 9 | PHS - So California | 0 | |
| Providence Blanchet Association | |||||||||||
| 1700 Providence Pl | Centralia | WA | 98531 | 911789266 | Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| St Luke Association | |||||||||||
| 350 Washington Ave SE | Chehalis | WA | 98352 | 943176618 | Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence Rossi Association | |||||||||||
| 1700 Providence Pl | Centralia | WA | 98531 | 311584166 | Housing | WA | 501( c)(3) | Line 9 | PH & S - Washington | 0 | |
| Lundberg Association | |||||||||||
| 5921 E Burnside | Portland | OR | 97215 | 911562797 | Housing | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence St Francis Association | |||||||||||
| 3415 12th Avenue NE | Olympia | WA | 98506 | 943244854 | Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence Peter Claver Association | |||||||||||
| 7101 38th Avenue South | Seattle | WA | 98118 | 311629656 | Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence St Elizabeth House Association | |||||||||||
| 3201 SW Graham St | Seattle | WA | 98126 | 912171539 | Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence Gamelin House Association | |||||||||||
| 4515 MLK Jr Way S Ste 200 | Seattle | WA | 98108 | 311744654 | Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| The Gamelin Association | |||||||||||
| 312 North Fourth St | Yakima | WA | 98901 | 911180824 | Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| The Gamelin Oregon Association | |||||||||||
| 5520 NE Glisan | Portland | OR | 97213 | 911214491 | Housing | OR | 501( c)(3) | Line 9 | PH & S - Oregon | 0 | |
| The Gamelin California Association | |||||||||||
| 540 23rd St | Oakland | CA | 94612 | 911293869 | Housing | CA | 501( c)(3) | Line 9 | PHS - So California | 0 | |
| Gamelin Washington Association | |||||||||||
| 1423 First Avenue | Seattle | WA | 98101 | 201910170 | Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence Foundation | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 943078543 | Support PH&S Institutions | WA | 501( c)(3) | Line 11/Type I | PH & S - Washington | 0 | |
| Providence Alaska Foundation | |||||||||||
| 3300 Providence Drive - B Tower2 | Anchorage | AK | 99508 | 920093565 | Support PHS-Alaska | AK | 501( c)(3) | Line 11/Type I | PH & S - Washington | 0 | |
| Providence St Peter Foundation | |||||||||||
| 413 Lilly Road NE | Olympia | WA | 985065166 | 911097056 | Support Affiliated Tax-Exempt Organization | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence Health Care Foundation (Centralia) | |||||||||||
| 914 S Scheuber Road | Centralia | WA | 98531 | 911433382 | Support Providence Centralia Hospital | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence Mount St Vincent Foundation | |||||||||||
| 4831 - 35th Avenue SW | Seattle | WA | 981262799 | 911188119 | Support Providence Mount St.Vincent | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence Marianwood Foundation | |||||||||||
| 3725 Providence Point Drive SE | Issaquah | WA | 980297219 | 931554288 | Support Providence Marianwood | WA | 501( c)(3) | Line 11/Type I | PH & S - Washington | 0 | |
| Providence Newberg Health Foundation | |||||||||||
| 1001 Providence Drive | Newberg | OR | 97132 | 930889144 | Support Providence Newberg Medical Center | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence Seaside Hospital Foundation | |||||||||||
| 725 S Wahanna Rd | Seaside | OR | 97138 | 930927320 | Support Providence Seaside Hospital | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence Community Health Foundation | |||||||||||
| 1111 Crater Lake Ave | Medford | OR | 97504 | 930692907 | Support Providence Medford Medical Center | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence Benedictine Nursing Center Foundation | |||||||||||
| 540 South Main St | Mt Angel | OR | 973629532 | 911940286 | Support Providence Benedictine Nursing Center | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence Portland Medical Foundation | |||||||||||
| 4805 NE Glisan St | Portland | OR | 972132967 | 931231494 | Support Providence Portland Medical Center | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence St Vincent Medical Foundation | |||||||||||
| 9205 SW Barnes Rd | Portland | OR | 97225 | 930575982 | Support Providence St. Vincent Medical Center | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence Milwaukie Foundation | |||||||||||
| 10150 SE 32nd | Milwaukie | OR | 97222 | 943079515 | Support Providence Milwaukie Hospital | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence Child Center Foundation | |||||||||||
| 830 NE 47th | Portland | OR | 97213 | 930800140 | Support Providence Child Center | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence TrinityCare Hospice Foundation | |||||||||||
| 5315 Torrance Blvd Suite B1 | Torrance | CA | 90503 | 330261016 | Support TrinityCare Hospice | CA | 501( c)(3) | Line 7 | PHS - So California | 0 | |
| Providence Little Company of Mary Foundation | |||||||||||
| 4101 Torrance Blvd | Torrance | CA | 90503 | 510224944 | Support Little Company of Mary Service Area | CA | 501( c)(3) | Line 7 | PHS - So California | 0 | |
| PH&S FoundationSFVSA & SCVSA | |||||||||||
| 501 S Buena Vista Street | Burbank | CA | 91505 | 953544877 | Support Program & Activities of SFVSA & SCVSA | CA | 501( c)(3) | Line 7 | PHS - So California | 0 | |
| Providence Hospice of Seattle Foundation | |||||||||||
| 425 Pontius Avenue North 300 | Seattle | WA | 981095452 | 912077378 | Support Hospice of Seattle | WA | 501( c)(3) | Line 11/Type I | PH & S - Washington | 0 | |
| Providence Health & Services - Western Washington | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 911303277 | Healthcare | WA | 501( c)(3) | Line 3 | Providence MinistriesWHC | 0 | |
| Providence Health & Services | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 911549796 | Shell Corporation | WA | 501( c)(3) | Line 11/Type I | 0 | N/A | |
| Providence Health & Services - Montana | |||||||||||
| 500 W Broadway PO Box 4587 | Missoula | MT | 598064587 | 810231793 | Healthcare | MT | 501( c)(3) | Line 3 | PH & S - Washington | 0 | |
| Providence St Joseph Medical Center | |||||||||||
| PO Box 1010 | Polson | MT | 598601010 | 810463482 | Healthcare | MT | 501( c)(3) | Line 3 | PH & S - Washington | 0 | |
| St Thomas Child and Family Center | |||||||||||
| 1710 Benefis Court | Great Falls | MT | 59405 | 810233495 | Early Childhood Education | MT | 501( c)(3) | Line 1 | PH & S - Washington | 0 | |
| Sisters of Providence of Montana Corporation | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 262612415 | Shell Corporation | MT | 501( c)(3) | Line 1 | PH & S - Washington | 0 | |
| Providence Health Care Foundation - Eastern Washington | |||||||||||
| 101 W 8th Ave | Spokane | WA | 99204 | 320014330 | Support PH&S-WA. Ministries in E. WA. | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| St Patrick Hospital Foundation | |||||||||||
| 500 West Broadway PO Box 4587 | Missoula | MT | 598064587 | 237056976 | Support Healthcare in W. Montana | MT | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| University of Great Falls | |||||||||||
| 1301 20th Street South | Great Falls | MT | 59405 | 810231777 | Post Secondary Education | MT | 501( c)(3) | Line 2 | PH & S - Washington | 0 | |
| E WA & MT Unemployment Compensation Insurance Trust | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 911082119 | Unemployment Benefits | WA | 501( c)(3) | Line 11/Type I | PH & S - Washington | 0 | |
| Providence Willamette Falls Medical Foundation | |||||||||||
| 1500 Division Street | Oregon City | OR | 97045 | 931003750 | Support Willamette Falls Hospital | OR | 501( c)(3) | Line 11/Type I | PH & S - Oregon | 0 | |
| Providence Hood River Memorial Hospital Foundation Inc | |||||||||||
| 811 13th St | Hood River | OR | 97031 | 930921990 | Support Providence Hood River Memorial Hospital | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence Hospice and Home Care Foundation | |||||||||||
| 2731 Wetmore Avenue Suite 500 | Everett | WA | 98201 | 272552749 | Support Program & Ministries of PHHC | WA | 501(c )(3) | Line 7 | PH & S - Washington | 0 | |
| Providence St Mary Foundation | |||||||||||
| 401 W Poplar St | Walla Walla | WA | 99362 | 452841492 | Support Program & Ministries of SMMC | WA | 501(c )(3) | Line 7 | PH & S - Washington | 0 | |
| Facey Medical Foundation | |||||||||||
| 15451 San Fernando Mission Blvd 200 | Mission Hills | CA | 913451420 | 954322584 | Support Facey Medical Group | CA | 501(c )(3) | Line 7 | PHS - So California | 0 | |
| Swedish Health Services | |||||||||||
| 747 Broadway | Seattle | WA | 98122 | 910433740 | Healthcare | WA | 501(c )(3) | Line 3 | Western HealthConnect | 0 | |
| Swedish Edmonds | |||||||||||
| 21601 76th Ave W | Edmonds | WA | 98026 | 272305304 | Healthcare | WA | 501(c )(3) | Line 3 | Western HealthConnect | 0 | |
| Swedish Medical Center Foundation | |||||||||||
| 747 Broadway | Seattle | WA | 98122 | 910983214 | Support Swedish Health Services | WA | 501(c )(3) | Line 7 | Swedish Health Services | 0 | |
| Global To Local Health Initiative | |||||||||||
| 747 Broadway | Seattle | WA | 98122 | 273133200 | Healthcare | WA | 501(c )(3) | Line 7 | Swedish Health Services | 0 | |
| Swedish MJM Holdings | |||||||||||
| 747 Broadway | Seattle | WA | 98122 | 273139262 | Holding Company | WA | 501(c )(3) | Line 11/Type I | Swedish Health Services | 0 | |
| Marsha Rivkin Center for Ovarian Cancer Research | |||||||||||
| 747 Broadway | Seattle | WA | 98122 | 912054035 | Ovarian Cancer Research | WA | 501(c )(3) | Line 7 | Swedish Health Services | 0 | |
| Western HealthConnect | |||||||||||
| 747 Broadway | Seattle | WA | 98122 | 454171900 | Shell Corporation | WA | 501(c )(3) | Line 11/Type I | PH&S Western Washington | 0 | |
| Inland Northwest Health Services | |||||||||||
| 601 W 1st Avenue | Spokane | WA | 99201 | 911307555 | Healthcare | WA | 501( c)(3) | Line 3 | PH&S - Washington | 0 | |
| PHN Holdings | |||||||||||
| 20555 Earl Street | Torrance | CA | 90503 | 461814184 | Strategic/Planning services for PHN | CA | 501( c)(4) | Pending | PHS - So California | 0 | |
| Providence Health Network | |||||||||||
| 20555 Earl Street | Torrance | CA | 90503 | 800886966 | Prepaid Healthcare | CA | 501( c)(4) | Pending | PHN Holdings | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (24 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| Alpha Medical Laboratory LLC | |||||||
| 611 N Perry | Spokane | WA | 99202 | 912017347 | Outpatient Lab | ID | N/A |
| Broadway Imaging LLC | |||||||
| 500 W Broadway | Missoula | MT | 59802 | 522405971 | Medical Imaging | MT | N/A |
| California Laboratory Associates LLC | |||||||
| 501 Buena Vista | Burbank | CA | 91505 | 273888692 | Outpatient Lab | CA | N/A |
| Center for Specialty Surgery LLC | |||||||
| 11782 SW Barnes Rd | Portland | OR | 97225 | 263638838 | Ambulatory Surgery Center | OR | N/A |
| Clackamas Radiation Oncology Center LLC | |||||||
| 4400 NE Halsey St Bldg II 495 | Portland | OR | 97213 | 260381897 | Radiation Oncology | OR | N/A |
| Ctr for Med Imaging-Bridgeport LLC | |||||||
| 4400 NE Halsey St Bldg II 495 | Portland | OR | 97213 | 260796953 | Imaging - Diagnostics | OR | N/A |
| Ctr for MedImaging-Tanasbourne LLC | |||||||
| 4400 NE Halsey St Bldg II 495 | Portland | OR | 97213 | 200477972 | Imaging - Diagnostics | OR | N/A |
| Greater Valley Medical Building LP | |||||||
| 501 S Buena Vista St | Burbank | CA | 91505 | 954570858 | Real Estate - MOB | CA | N/A |
| Medalia Healthcare LLC | |||||||
| 1801 Lind Ave SW 9016 | Renton | WA | 98057 | 911660459 | Physician Benefits | WA | N/A |
| Minor & James Medical PLLC | |||||||
| 515 Minor Avenue 200 | Seattle | WA | 98104 | 911340223 | Physician Clinic | WA | N/A |
| Mountainstar Clinical Laboratories LLC | |||||||
| 611 N Perry | Spokane | WA | 99202 | 261345983 | Outpatient Lab | MT | N/A |
| Oregon Advanced Imaging LLC | |||||||
| 881 OHare Parkway | Medford | OR | 97504 | 450471748 | Medical Imaging | OR | N/A |
| Oregon Outpatient Surgery Center | |||||||
| 7300 SW Childs Rd | Tigard | OR | 97224 | 223883387 | Ambulatory Surgery Center | OR | N/A |
| PacLab LLC | |||||||
| 611 N Perry | Spokane | WA | 99202 | 911743952 | Outpatient Lab | WA | N/A |
| Pathology Associates Medical Laboratories LLC | |||||||
| 611 N Perry | Spokane | WA | 99202 | 270943279 | Outpatient Lab | WA | N/A |
| PETCT Imaging at Swedish Cancer Institute LLC | |||||||
| 1221 Madison Street | Seattle | WA | 98104 | 203132044 | Medical Imaging | WA | N/A |
| Portland Medical Imaging LLC | |||||||
| 4400 NE Halsey St Bldg II 495 | Portland | OR | 97213 | 201054971 | Imaging - Diagnostics | OR | N/A |
| Prov Radiation Oncology Develop Assn LLC | |||||||
| 4401 NE Halsey St Bldg II 495 | Portland | OR | 97213 | 260682491 | Real Estate - MOB | OR | N/A |
| Providence Imaging Center | |||||||
| 3340 Providence Drive | Anchorage | AK | 99508 | 920118807 | Medical Imaging | AK | N/A |
| Providence Partners for Health LLC | |||||||
| 501 S Buena Vista St | Burbank | CA | 91505 | 454041798 | Clinical Quality & Integration | CA | N/A |
| ProvidenceUSP Santa Clarita GP LLC | |||||||
| 11550 Indian Hills Road 160 | Mission Hills | CA | 91345 | 202829660 | Ambulatory Surgery Center | CA | N/A |
| ProvidenceUSP Surgery Ctrs LLC | |||||||
| 11550 Indian Hills Road 160 | Mission Hills | CA | 91345 | 200905938 | Ambulatory Surgery Center | CA | N/A |
| Southern Idaho Regional Laboratory LLC | |||||||
| 611 N Perry | Spokane | WA | 99202 | 820511819 | Outpatient Lab | ID | N/A |
| Tri-Cities Laboratory LLC | |||||||
| 611 N Perry | Spokane | WA | 99202 | 911773986 | Outpatient Lab | WA | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| Providence Health Ventures Inc | |||||||||
| 4101 Torrance Blvd | Torrance | CA | 90503 | 330122216 | Investment | CA | N/A | C | 0 |
| Caron Health Corporation | |||||||||
| 510 W Front St | Missoula | MT | 59802 | 810486082 | Medical Physician Service | MT | N/A | C | 0 |
| Providence Health Care Ventures Inc | |||||||||
| 101 W 8th Ave TAF C-9 | Spokane | WA | 99204 | 900155714 | Clinical/Medical Lab | WA | N/A | C | 0 |
| Providence Physician Services Co | |||||||||
| 101 W 8th Ave TAF C-9 | Spokane | WA | 99204 | 911216033 | Clinical/Medical Lab | WA | N/A | C | 0 |
| Yakima Medical Arts Inc | |||||||||
| 611 N Perry 100 | Spokane | WA | 99202 | 910787963 | Rental Real Estate | WA | N/A | C | 0 |
| Bourget Health Services Inc | |||||||||
| PO Box 2687 | Spokane | WA | 99220 | 911354431 | Clinical/Medical Lab | WA | N/A | C | 0 |
| 1221 Madison Street Owners Assoc | |||||||||
| 747 Broadway | Seattle | WA | 98122 | 201954319 | Owners' Association | WA | N/A | C | 0 |
| Washington Cancer Centers PC | |||||||||
| 1560 N 115th G-16 | Seattle | WA | 98133 | 911792791 | Cancer Treatment | WA | N/A | C | 0 |
| Western HealthConnect Ventures Inc | |||||||||
| 1801 Lind Ave SW 9016 | Renton | WA | 98057 | 800953654 | Investment | WA | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Providence Plan Partners | ||
| P | $123,930,197 | Cost |
| Providence Health Assurance | ||
| B | $2,000,000 | Cost |
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