2014-06-19T18:12:34-05:00 2013-12-31 910189318 MOSS ADAMS LLP 805 SW BROADWAY SUITE 1200 PORTLAND OR 97205 990 2013-01-01 810480587 BENEFIS HEALTH SYSTEM FOUNDATION INC BENE 4064555840 PO BOX 7008 GREAT FALLS MT 59406 DAN HOLLOW PRESIDENT 4064555840 2014-06-11 1 WENDY CAMPOS P00448102 5032421447 2013 2015-11-30 17:44:51Z DAN HOLLOW PO BOX 7008 GREAT FALLS MT 59406 5980578 0 X WWW.BENEFISFOUNDATION.ORG X 1998 MT IMPROVING AND ENHANCING HEALTHCARE SERVICES FOR PEOPLE THROUGHOUT NORTH CENTRAL MONTANA. 15 13 0 110 0 0 1983562 2419717 0 0 691076 782097 197365 205564 2872003 3407378 1684594 2163175 0 0 0 0 0 0 0 160530 200892 1845124 2364067 1026879 1043311 23938106 27755883 469011 511742 23469095 27244141 X IMPROVING AND ENHANCING HEALTHCARE SERVICES FOR PEOPLE THROUGHOUT NORTH CENTRAL MONTANA. 0 0 2163175 2163175 BENEFIS HEALTH SYSTEM FOUNDATION'S PURPOSE IS TO IMPROVE AND ENHANCE HEALTHCARE SERVICES FOR THE PEOPLE OF NORTH CENTRAL MONTANA. THE FOUNDATION RAISES FUNDS TO PRIMARILY SUPPORT THE PROGRAMS AND SERVICES OF BENEFIS HEALTH SYSTEM BUT ALSO SUPPORTS OTHER HEALTH-RELATED PROGRAMS, SERVICES AND ACTIVITIES IN NORTH CENTRAL MONTANA. SOME OF THE PROGRAMS AND SERVICES OF BENEFIS HEALTH SYSTEM SUPPORTED BY CONTRIBUTIONS RAISED BY THE FOUNDATION INCLUDE PEACE HOSPICE OF MONTANA, SLETTEN CANCER INSTITUTE, GIFT OF LIFE FAMILY HOUSING CENTERS, MERCY FLIGHT, DIALYSIS, AND THE BENEFIS HEART AND VASCULAR INSTITUTE. CONTINUES ON SCHEDULE OCONTINUED FROM PAGE 2, PART III, LINE 4A: BENEFIS HEALTH SYSTEM FOUNDATION ALSO ENCOURAGES CONTRIBUTIONS TO ITS ANGEL FUND AND 221 CHILDREN'S FUND, WHICH HELP FAMILIES WITH CHILDREN WITH MEDICAL CONDITIONS OR A MEDICAL CRISIS. IN ADDITION, THE FOUNDATION RAISES FUNDS FOR AND MANAGES SEVERAL HEALTHCARE SCHOLARSHIPS. 2163175 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 0 0 0 0 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 1 22 0 1 0 0 0 0 0 1 1 1 1 0 0 0 0 X 15 13 1 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X DALE BIMLER 4064552565 500 15TH AVE SOUTH GREAT FALLS MT 59405 RICHARD DOUGHTEN CHAIR 1.00 X X 0 0 0 NORBERT JOHNSON VICE CHAIR 3.00 X X 0 0 0 BRYCE GRAFT SECRETARY 1.00 2.00 X X 0 0 0 DOUGLAS M NICHOLSON TREASURER 3.00 X X 0 0 0 SHANNON HOILAND DIRECTOR 1.00 X 0 0 0 DENA JOHNSON DIRECTOR 3.00 X 0 0 0 CHRIS REIQUAM DIRECTOR 3.00 2.00 X 0 0 0 BARBARA BYRNE DIRECTOR 3.00 X 0 0 0 PATRICIA SLETTEN DIRECTOR 3.00 X 0 0 0 EUGENE B THAYER DIRECTOR 3.00 X 0 0 0 G MIKE TABACCO DIRECTOR 3.00 X 0 0 0 DIANE VOLK DIRECTOR 3.00 X 0 0 0 NORA GERRITY MD DIRECTOR 3.00 40.00 X 0 200230 9360 JOHN GOODNOW EX-OFFICIO DIRECTOR 3.00 57.00 X 0 832786 165528 CHRIS EBELING EX-OFFICIO DIRECTOR 3.00 4.00 X 0 0 0 DANIEL HOLLOW PRESIDENT 50.00 X 0 119520 14764 MARILYN PARKER DIRECTOR OF PLANNED GIVING 50.00 X 0 70680 5657 0 1223216 195309 0 0 1 0 0 183 6000 2413534 2419717 728595 728595 2514447 2460945 53502 53502 53502 289440 183 96642 192798 192798 28379 15613 12766 12766 3407378 0 0 987661 2023350 2023350 139825 139825 200892 200892 2364067 2163175 200892 0 43572 -13588 917191 1456596 730787 575202 423966 282812 15285 15400 15285 21113603 24947766 188844 121362 504743 370448 23938106 27755883 78042 101155 390969 410587 469011 511742 X 3607122 4262297 5942822 7786876 13919151 15194968 23469095 27244141 23938106 27755883 X 1043311 2730783 952 X X 0 1 X 1 0 X 2009793 2169377 1151749 1983562 1619724 8934205 2009793 2169377 1151749 1983562 1619724 8934205 677654 8256551 341581 842210 522217 611458 728595 3046061 11980266 900026 0.68920 0.72410 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 19058513 1274865 2278824 343934 104929 22163339 15998563 1253995 2099380 205187 88238 19058513 15914819 314429 39106 180722 89069 15998563 14761079 836277 792950 475487 15914819 7920043 5495559 1400486 55009 14761079 0.12320 0.68560 0.19120 0 0 15285 15285 15285 GIFT ANNUITY PAYABLE 410587 410587 X 6998621 2730783 859508 952 3591243 3407378 0 3407378 3223575 859508 859508 2364067 0 2364067 PART V, LINE 4: THE ENDOWMENT FUNDS OF THE FOUNDATION CONSIST OF THE FOLLOWING: THE FUNDS IN THE GENERAL ENDOWMENT ARE RESTRICTED BY DONORS AS PERMANENT ENDOWMENT FUNDS BUT HAVE NO SPECIFIC RESTRICTION ON THE DISTRIBUTION OF EARNINGS. THIS DECISION IS THE RESPONSIBILITY OF THE BOARD OF DIRECTORS OF BENEFIS HEALTH SYSTEM FOUNDATION. THE PEACE HOSPICE RESIDENTIAL ENDOWMENT PROVIDES FOR THE OPERATION AND MAINTENANCE OF THE BENEFIS PEACE HOSPICE RESIDENTIAL FACILITY. BENEFIS PEACE HOSPICE IS A SERVICE OF BENEFIS HEALTH SYSTEM. THE DONOR RESTRICTED ENDOWMENT POOL HOLDS GIFTS FROM DONORS FOR PERMANENT ENDOWMENT FUNDS THAT HAVE SPECIFIC DESIGNATIONS FOR THE USE OF THE EARNINGS OF EACH FUND. THESE MAY INCLUDE FUNDS FOR PROGRAMS OR SERVICES OR SCHOLARSHIPS. BENEFIS HEALTH SYSTEM FOUNDATION ISSUES CHARITABLE GIFT ANNUITIES AND DEFERRED PAYMENT CHARITABLE GIFT ANNUITIES AND HAS ESTABLISHED A GIFT ANNUITY POOL TO HOLD THESE FUNDS AS REQUIRED UNDER THE MONTANA CHARITABLE GIFT ANNUITY ACT. THE PURPOSES OF THE FUNDS IN THE POOL ARE DEFINED BY THE INDIVIDUAL ANNUITY CONTRACTS. PART X, LINE 2: THE FOUNDATION IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE IRC. THE FOUNDATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE IRC EXCEPT TO THE EXTENT OF UNRELATED BUSINESS TAXABLE INCOME AS DEFINED UNDER IRC SECTIONS 511 THROUGH 515. EFFECTIVE JANUARY 1, 2009, THE FOUNDATION ADOPTED ACCOUNTING FOR UNCERTAIN TAX POSITIONS. THE ACCOUNTING STANDARD PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR UNCERTAIN TAX POSITIONS. THE FOUNDATION HAD NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2013 OR 2012. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF CHARITABLE GIFT ANNUITY 952. MAYFAIRE 289623 183 289440 34414 15383 29442 17403 289623 183 289440 34414 15383 29442 17403 96642 192798 28379 12613 3000 0 28379 12613 3000 15613 12766 MT 1 0 1 0 1.00000 MARILYN PARKER PO BOX 7008 GREAT FALLS MT 59406 0 MARILYN PARKER 141 CREATE AND OVERSEE THE CALCULATION FOR THE TOURNAMENT RECORD KEEPING AND PAYOUT TO PLAYERS. X 0 1 BENEFIS HEALTH SYSTEM 1101 26TH ST S GREAT FALLS MT 59405 263538104 501(C)(3) 1917414 SUPPORT VARIOUS PROGRAMS AND PROJECTS BENEFIS HOSPITALS 1101 26TH ST S GREAT FALLS MT 59405 810232122 501(C)(3) 57089 SUPPORT VARIOUS PROGRAMS AND PROJECTS MISSOURI RIVER MEDICAL CENTER PO BOX 249 FORT BENTON MT 59442 810348783 MT HOSPITAL DISTRICT 16500 SUPPORT VARIOUS PROGRAMS AND PROJECTS 3 0 ANGEL FUND - PROVIDES FINANCIAL ASSISTANCE TO FAMILIES WITH CHILDREN WHO HAVE CATASTROPHIC ILLNESSES. 56 38970 CARING FOR OUR OWN - PROVIDES FINANCIAL ASSISTANCE TO BENEFIS HEALTH SYSTEM EMPLOYEES OR VOLUNTEERS WHO EXPERIENCE AN EMERGENCY. 93 56648 NURSING SCHOLARSHIPS - SCHOLARSHIPS TO ELIGIBLE STUDENTS ADVANCING THEIR HEALTHCARE EDUCATION, SOME OF WHOM ARE WILLING TO SIGN A WORK COMMITMENT AGREEMENT WITH BENEFIS HEALTH SYSTEM. 25 40207 221 CHILDREN'S FUND - PROVIDES FINANCIALS ASSISTANCE OR PRESCRIPTIONS TO CHILDREN WHO ARE SUFFERING WITH A TERRIBLE ILLNESS OR DISEASE. 8 4000 PART I, LINE 2: BENEFIS HEALTH SYSTEM FOUNDATION HAS AN APPLICATION PROCESS FOR POTENTIAL GRANT RECIPIENTS. THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS THE SUBMITTED APPLICATIONS AND ADHERES TO A FUNDS ALLOCATION POLICY, AS WELL AS NEED, WHEN CHOOSING RECIPIENTS. AFTER RECIPIENTS ARE CHOSEN, THE FOUNDATION COMMUNICATES FREQUENTLY WITH GRANTEES. THEY REQUIRE PROOF THAT THE FUNDS ARE SPENT ACCORDING TO THE APPLICATIONS SUBMITTED. THE TYPE OF PROOF THAT IS REQUIRED IS DETERMINED ON A CASE-BY-CASE BASIS; FOR INSTANCE, THEY MAY REQUIRE RECEIPTS AS WELL AS REPORTS CONTAINING DETAILS ON HOW THE MONEY WAS USED, WHO BENEFITTED, AND STORIES FROM THOSE WHO BENEFITTED. THE BENEFIS HEALTH SYSTEM FOUNDATION GRANTS FUNDS TO BENEFIS HEALTH SYSTEM IN SUPPORT OF MANY OF THEIR HOSPITAL PROGRAMS, DEPARTMENTS AND PROJECTS: PEACE HOSPICE AND PEACE HOSPICE RESIDENTIAL FACILITY- $1,141,458 SLETTEN CANCER INSTITUTE AND ONCOLOGY PROGRAMS $285,302 NEONATAL INTENSIVE CARE UNIT $28,010 CHILDRENS BEREAVEMENT AND CAMP FRANCIS $ 27,778 PEDIATRICS $24,724 MERCY FLIGHT $21,238 LABOR AND DELIVERY $16,175 GIFT OF LIFE HOUSING $7,253 VARIOUS OTHER PROGRAMS AND SERVICES $422,565 TOTAL FOR BENEFIS HEALTH SYSTEM = $1,974,503 X X 1 1 X X X X X 0 0 0 0 0 0 0 0 0 NORA GERRITY MD DIRECTOR 0 200230 0 0 0 0 0 0 0 9360 0 209590 0 0 JOHN GOODNOW EX-OFFICIO DIRECTOR 0 558360 0 118115 0 156311 0 157860 0 7668 0 998314 0 143900 PART I, LINE 1A TRAVEL FOR COMPANIONS AND HEALTH OR SOCIAL CLUB DUES THAT BHS PAYS FOR ITS OFFICERS ARE TREATED AS TAXABLE INCOME TO THE INDIVIDUAL ACCORDINGLY. X 9 178497 DISCOUNTED PRESENT VALUE X BABY AND MISC 59 4956 PURCHASE PRICE 0 0 1 0 FORM 990, PART VI, SECTION A, LINE 1 THE ORGANIZATION IS AN AFFILIATE OF BENEFIS HEALTH SYSTEM, INC. (BHS), A TAX EXEMPT MONTANA NON-PROFIT CORPORATION SERVING AS THE PARENT ENTITY OF AN INTEGRATED SYSTEM OF PROVIDER ORGANIZATIONS ADDRESSING THE HEALTH NEEDS OF PERSONS THROUGHOUT NORTH CENTRAL MONTANA. AS THE CORPORATE MEMBER OF THE ORGANIZATION, BHS HOLDS VARIOUS RESERVED POWER IN RELATION TO THE ORGANIZATION, INCLUDING THE AUTHORITY TO ELECT ITS BOARD OF DIRECTORS. THE BOARD OF DIRECTORS OF THE ORGANIZATION INCLUDES CERTAIN INDIVIDUALS WHO ARE EMPLOYED BY THE ORGANIZATION OR ITS AFFILIATES, AND WHO MAY NOT BE CONSIDERED "INDEPENDENT" FOR PURPOSES OF FORM 990. HOWEVER, AS ACKNOWLEDGED BY THE IRS IN ITS "CPE TEXT FOR FISCAL YEAR 1997", IN A MULTI-ENTITY HOSPITAL SYSTEM, THE BOARD OF A SUBSIDIARY NON-PROFIT HEALTH CARE ORGANIZATION IS CONSIDERED TO BE COMPRISED OF INDEPENDENT COMMUNITY MEMBERS IF IT IS CONTROLLED BY AN EXEMPT ORGANIZATION WHOSE OWN BOARD IS COMPRISED OF A MAJORITY OF VOTING MEMBERS WHO ARE INDEPENDENT COMMUNITY MEMBERS. THE ORGANIZATION MEETS THIS STANDARD BECAUSE IT IS A CONTROLLED SUBSIDIARY OF BHS, AND BHS'S OWN GOVERNING BOARD INCLUDES INDEPENDENT COMMUNITY MEMBERS AS A MAJORITY THEREOF. FORM 990, PART VI, SECTION A, LINE 2 CERTAIN OF THE OFFICERS AND DIRECTORS LISTED IN PART VII ALSO HOLD OFFICER AND/OR DIRECTOR POSITIONS IN RELATION TO THE ORGANIZATION'S AFFILIATES (AS IDENTIFIED IN SCHEDULE R) AND, IN THAT REGARD, MAY BE CONSIDERED TO HAVE BUSINESS RELATIONSHIPS WITH EACH OTHER. FORM 990, PART VI, SECTION A, LINE 3 PURSUANT TO A CONTRACTUAL ARRANGEMENT, THE ORGANIZATION OBTAINS CERTAIN MANAGEMENT AND ADMINISTRATIVE SERVICES FROM ITS PARENT ENTITY, BENEFIS HEALTH SYSTEM, INC. (BHS). BHS PROVIDES THESE SERVICES TO ITS SUBSIDIARY TAX-EXEMPT OPERATING ENTITIES ON A CENTRALIZED BASIS. THE SERVICES INCLUDE THE FOLLOWING: - MANAGEMENT OF HUMAN RESOURCES INCLUDING POLICIES AND PRACTICES - MANAGEMENT, PLANNING, BUDGETING AND REPORTING OF FINANCIAL OPERATIONS - INFORMATION SYSTEMS COORDINATION - OVERSEES QUALITY STANDARDS, COMPLIANCE AND RISK MANAGEMENT - MANAGES REGIONAL, COMMUNITY AND GOVERNMENT RELATIONS AND MARKETING - MANAGEMENT OF GRANTS DEVELOPMENT THE BOARD OF DIRECTORS OF BHS ALSO OVERSEES ALL OF THE ORGANIZATION'S BOARD ACTIVITIES. THE FOLLOWING PERSONS LISTED IN PART VII WERE COMPENSATED BY BHS: JOHN GOODNOW - $832,786 (COMPENSATION FOR SERVICES AS OFFICER OF BHS) DANIEL HOLLOW - $119,520 MARILYN PARKER - $70,680 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER OF THE ORGANIZATION IS BENEFIS HEALTH SYSTEM, INC., A MONTANA NON-PROFIT PUBLIC BENEFIT CORPORATION THAT HAS BEEN RECOGNIZED BY THE IRS AS DESCRIBED IN IRC SECTION 501(C)(3). FORM 990, PART VI, SECTION A, LINE 7A BENEFIS HEALTH SYSTEM IS THE SOLE VOTING MEMBER AND HAS THE FOLLOWING RESERVE POWERS OVER BENEFIS HEALTH SYSTEM FOUNDATION: - TO ELECT THE DIRECTORS TO THE BOARD AND OFFICERS OF THE FOUNDATION AND REMOVE ANY DIRECTOR OR OFFICER OF THE FOUNDATION - TO INITIATE AND APPROVE ANY PLAN OF MERGER, CONSOLIDATION OR DISSOLUTION INVOLVING THE FOUNDATION - TO APPROVE ALL AMENDMENTS TO THE FOUNDATION'S ARTICLES OF INCORPORATION AND BYLAWS - TO CONTINUOUSLY REVIEW AND MONITOR THE FINANCIAL CONDITION OF THE FOUNDATION, INCLUDING THROUGH AN ANNUAL AUDIT - TO APPROVE THE ANNUAL BUDGET OF THE FOUNDATION AND ALL MATERIAL DEVIATIONS FROM THE APPROVED BUDGET - TO DELINEATE BY POLICY THE REQUIREMENTS FOR APPROVAL OF ALL ARRANGEMENTS AND TRANSACTIONS INVOLVING THE ASSETS AND FINANCES OF THE FOUNDATION - TO SET THE COMPENSATION FOR ALL OF THE OFFICERS OF THE FOUNDATION, INCLUDING THE PRESIDENT - TO APPROVE ALL MISSION AND/OR VISION STATEMENTS AND ALL STRATEGIC OR LONG-TERM PLANS OF THE FOUNDATION - TO APPROVE THE CREATION, ACQUISITION, DISPOSTION OR TERMINATION OF THE SUBSIDIARIES OR CONTROLLED AFFILIATES, AND ANY MERGERS, CONSOLIDATIONS, AND PERMANENT OR LONG-TERM AFFILIATIONS OF THE FOUNDATION OR ANY OF ITS SUBSIDIARIES OR CONTROLLED ENTITIES - TO APPOINT A CERTIFIED PUBLIC ACCOUNTANT TO PERFORM THE ANNUAL AUDIT OF THE FOUNDATION'S FINANCIAL STATEMENTS IN CONJUNCTION WITH THE ANNUAL AUDIT OF THE MEMBER'S FINANCIAL STATEMENTS - TO APPROVE ANY AGREEMENT THAT OBLIGATES THE FOUNDATION TO PAY OR INCUR LIABILITY OF MORE THAN TEN THOUSAND DOLLARS ($10,000), AND TO APPROVE ANY AGREEMENT THAT OBLIGATES THE FOUNDATION TO PAY AN AMOUNT OR INCUR A LIABILITY NOT INCLUDED IN THE THEN CURRENT BUDGET OF THE FOUNDATION, WHICH WAS APPROVED BY THE MEMBER PURSUANT TO THESE POWERS LISTED - TO DETERMINE AND ENSURE COMPLIANCE WITH THE FOUNDATION'S STATED CHARITABLE PURPOSES - TO INITIATE AND APPROVE, IN CONSULTATION WITH THE BOARD, SUCH OPERATING POLICIES REGARDING THE FOUNDATION'S ACTIVITIES, OPERATIONS, FINANCES AND ASSETS AS IT DEEMS NECESSARY OR APPROPRIATE FROM TIME TO TIME - TO ENSURE THAT THE FOUNDATION IS HONORING THE INTENTIONS AND DIRECTIONS OF ALL OF ITS DONORS WITH RESPECT TO THE INVESTMENT AND USE OF THEIR DONATIONS FORM 990, PART VI, SECTION A, LINE 7B UNDER THE ARTICLES AND BYLAWS AMENDED DECEMBER 13, 2011, AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, BENEFIS HEALTH SYSTEM, INC. RETAINS CERTAIN RESERVED POWERS WITH RESPECT TO THE ORGANIZATION, INCLUDING AUTHORITY OVER MATTERS SUCH AS (WITHOUT LIMITATION) THE ORGANIZATION'S MISSION AND VISION STATEMENTS, STRATEGIC AND LONG-TERM PLANS, ELECTION OF ITS DIRECTORS AND OFFICERS, ANNUAL CAPITAL AND OPERATING BUDGETS, CHARITY CARE AND COMMUNITY BENEFIT POLICIES, AND ANY AMENDMENTS TO ITS ARTICLES OF INCORPORATION AND BYLAWS. FORM 990, PART VI, SECTION B, LINE 11 THIS FORM 990 WAS PREPARED BY THE FINANCE DEPARTMENT PERSONNEL OF BENEFIS HEALTH SYSTEM, INC. IN COLLABORATION WITH ITS ACCOUNTING FIRM. PRIOR TO FILING, A COPY OF THIS FORM 990 WAS DISTRIBUTED TO ALL MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS, WITH A PRESENTATION TO THE BOARD OF BENEFIS HEALTH SYSTEM, INC. BY THE ACCOUNTING FIRM. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ANNUALLY COMPLETE A FORM TO DISCLOSE INTERESTS THAT COULD GIVE RISE TO CONFLICTS. IN ADDITION, AT THE START OF EACH BOARD MEETING, MEMBERS ARE ASKED TO INDICATE WHETHER THEY HAVE A CONFLICT OF INTEREST WITH RESPECT TO ANY ITEMS ON THE AGENDA FOR THE MEETING. CONSISTENT WITH THE ORGANIZATION'S CONFLICTS OF INTEREST POLICY, BOARD MEMBERS ARE PROHIBITED FROM PARTICIPATING ON ANY MATTERS AS TO WHICH THEY HAVE A CONFLICT. FORM 990, PART VI, SECTION B, LINE 15A THE COMPENSATION OF THE PRESIDENT WAS SET BY THE INDEPENDENT COMPENSATION COMMITTEE OF BENEFIS HEALTH SYSTEM, INC., WHICH IS CHARGED WITH ADMINISTERING THE SYSTEM'S EXECUTIVE COMPENSATION PHILOSOPHY, POLICIES AND PROGRAMS IN THE MANNER SET FORTH IN THE COMMITTEE'S WRITTEN CHARTER. THE COMMITTEE'S RESPONSIBILITIES INCLUDE (I) DETERMINING APPROPRIATE COMPENSATION FOR ALL EXECUTIVES AND OTHER KEY EMPLOYEES, (II) EVALUATING AND ADOPTING EXECUTIVE COMPENSATION PLANS, POLICIES AND PROGRAMS, (III) REVIEWING AND APPROVING EXECUTIVE BENEFIT PLANS, AND (IV) VERIFYING THAT COMPENSATION IS APPROPRIATELY AND FULLY DISCLOSED AND REPORTED. THE COMMITTEE HAS ENGAGED AN INDEPENDENT COMPENSATION CONSULTING FIRM TO ASSIST IN ENSURING THAT AMOUNTS PAID TO THE SYSTEM'S EXECUTIVES ARE CONSISTENT WITH REASONABLE, FAIR MARKET LEVELS. THE PROCESS FOLLOWED BY THE COMMITTEE, INCLUDING THE DATA RELIED UPON AND THE COMMITTEE'S DECISIONS, WAS THOROUGHLY AND TIMELY DOCUMENTED. THE COMPENSATION OF THE ORGANIZATION'S OTHER OFFICERS, KEY EMPLOYEES AND MANAGERS WAS SET BY THEIR RESPECTIVE SUPERVISORY EXECUTIVES IN CONSULTATION WITH BENEFIS HEALTH SYSTEM, INC.'S HUMAN RESOURCES DEPARTMENT AND EXECUTIVE LEADERSHIP, BASED ON A REVIEW OF INDEPENDENT DATA AS TO AMOUNTS PAID BY SIMILARLY-SITUATED ORGANIZATIONS FOR PERSONS PERFORMING COMPARABLE SERVICES. FORM 990, PART VI, SECTION C, LINE 19 BENEFIS HEALTH SYSTEM FOUNDATION, INC. PROVIDES COPIES OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, FINANCIAL STATEMENTS, AND FORM 990 TO THE PUBLIC UPON REQUEST DURING NORMAL BUSINESS HOURS. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF CHARITABLE GIFT ANNUITY 952. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS NOT CHANGED EITHER ITS OVERSIGHT OR SELECTION PROCESS DURING THE YEAR. BENEFIS SLETTEN HI-LINE CANCER CENTER LLC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 263144419 MEDICAL CARE MT BENEFIS HEALTH SYSTEM INC BENEFIS CASCADE RIDGE LLC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 274602798 REAL ESTATE MT BENEFIS HEALTH SYSTEM INC BENEFIS HEALTH SYSTEM FOUNDATION PROPERTIES LLC PO BOX 7008 GREAT FALLS MT 59406 272514629 HOLDS REAL PROPERTY DONATED TO FOUNDATION MT 0 15285 BENEFIS HEALTH SYSTEM FOUNDATION INC BENEFIS HEALTH SYSTEM INC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 263538104 MANAGEMENT AND SUPPORT SERVICES MT 501(C)(3) SCHEDULE A, LINE 11 N/A 0 BENEFIS MEDICAL GROUP INC 1401 25TH STREET SOUTH GREAT FALLS MT 59405 263538192 PHYSICIAN SERVICES MT 501(C)(3) SCHEDULE A, LINE 3 BENEFIS HEALTH SYSTEM INC 0 BENEFIS SPECTRUM MEDICAL INC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 810431871 HOME HEALTH AND RELATED PRODUCTS MT 501(C)(3) SCHEDULE A, LINE 9 BENEFIS HEALTH SYSTEM INC 0 BENEFIS HOSPITALS INC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 810232122 HOSPITAL MT 501(C)(3) SCHEDULE A, LINE 3 BENEFIS HEALTH SYSTEM INC 0 BENEFIS HEALTHCARE EES HEALTH PLAN AND TRUST 1101 26TH STREET SOUTH GREAT FALLS MT 59405 363386166 BENEFIT PLAN MT 501(C)(9) BENEFIS HEALTH SYSTEM INC 0 BENEFIS SENIOR SERVICES INC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 461344408 SENIOR SERVICES/CRCC MT 501(C)(3) SCHEDULE A, LINE 9 BENEFIS HEALTH SYSTEM INC 0 SPECTRUM HOME SOLUTIONS 2509 7TH AVE SOUTH GREAT FALLS MT 59405 810431871 IV THERAPY MT N/A N/A 0 1 BBB LLC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 263652926 MEDICAL BUILDING MT N/A N/A 0 1 GREAT FALLS ATHLETIC CLUB LLC 1800 BENEFIS COURT GREAT FALLS MT 59405 912081505 FITNESS CLUB MT N/A N/A 0 1 0 1 1 0 0 0 0 0 0 0 0 1 1 1 1 0 1 0 0