2014-09-22T20:24:41-05:00 2013-12-31 ERNST & YOUNG US LLP 178 S RIO GRANDE STREET SUITE 400 SALT LAKE CITY UT 84101 990 2013-01-01 911729710 COMMUNITY HEALTH PLAN OF WASHINGTON % STACY KESSEL COMM 2066527174 720 OLIVE WAY Suite 300 SEATTLE WA 98101 Lance Hunsinger CEO 2014-09-17 8013503300 2013 2015-11-30 17:44:51Z LANCE HUNSINGER SAME AS C ABOVE SEATTLE WA 98101 977308762 false X WWW.CHPW.ORG X 1996 WA DELIVER MANAGED CARE SERVICES. 19 19 530 1 0 0 0 876212768 872740820 10665597 6067058 0 0 886878365 878807878 0 0 0 0 37450427 42180973 0 0 0 840603580 818183427 878054007 860364400 8824358 18443478 313999249 376921612 187907631 239122874 126091618 137798738 TO DELIVER ACCESSIBLE MANAGED CARE SERVICES WHICH MEET THE NEEDS AND IMPROVE THE HEALTH OF OUR COMMUNITIES, AND MAKE MANAGED CARE PARTICIPATION BENEFICIAL FOR COMMUNITY-RESPONSIVE PROVIDERS. false false 770387197 0 872740820 THE COMMUNITY HEALTH PLAN OF WASHINGTON (THE PLAN) PROVIDES HEALTHCARE SERVICES AND COVERAGE TO THE ENROLLEES OF THE STATE OF WASHINGTON DEPARTMENT OF SOCIAL AND HEALTH SERVICES (DSHS), HEALTH CARE AUTHORITY (HCA), HEALTHY OPTIONS (HO), CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP), HEALTHY OPTIONS BLIND & DISABLED (HOBD), AND MANAGED MEDICAID PROGRAMS AND MEDICAL CARE SERVICES (MCS). THE PLAN ALSO PROVIDES HEALTH COVERAGE TO ENROLLEES OF BASIC HEALTH AND MEDICARE ADVANTAGE. COVERAGE IS PROVIDED THROUGH A NETWORK OF CONTRACTED PROVIDERS. 770387197 false false false false false false false false false true false false false false true true true false false false false false false false false false false false true false false false false false false false false false false false false false true false false true 3643 0 true 530 true false false false false false false X 19 19 false false false false true true true true true false false true true true true true true true false true true X STACY KESSEL 2065218833 720 OLIVE WAY SUITE 300 SEATTLE WA 98101 X Bob Farrell Board Member 1.0 1.0 X 0 0 0 Dian Cooper Board Member 1.0 1.0 X 0 0 0 Michael Hassing Board Member 1.0 1.0 X 0 0 0 Desmond Skubi Board Member 1.0 1.0 X 0 0 0 Teresita Batayola Board Member 1.0 1.0 X 0 0 0 Mark Secord Board Member 1.0 1.0 X 0 0 0 Desiree Sweeney Board Member 1.0 1.0 X 0 0 0 Juan Cordova Board Member 1.0 1.0 X 0 0 0 Steven Clark Board Member 1.0 1.0 X 0 0 0 Anita Monoian Board Member 1.0 1.0 X 0 0 0 Peggy Hopkins Board Chair 1.0 1.0 X X 0 0 0 Thomas Trompeter Board Vice Chair 1.0 1.0 X X 0 0 0 Sheila Chilson Board Treasurer 1.0 1.0 X X 0 0 0 Barbara Malich Board Secretary 1.0 1.0 X X 0 0 0 Linda McVeigh Board Member 1.0 1.0 X 0 0 0 Carla DewBerry Board Member 1.0 1.0 X 0 0 0 Cristobal Guillen Board Member 1.0 1.0 X 12000 0 0 Diana Bader Board Member 1.0 1.0 X 15300 0 0 David Flentge Board Member 1.0 1.0 X 0 0 0 Lance Hunsinger Chief Executive Officer 27.0 13.0 X 984172 0 28174 Wade J Harman Chief Legal Officer 27.0 13.0 X 288444 0 20126 Stacy Kessel Chief Financial Officer 27.0 13.0 X 342518 0 18726 Marilee K McGuire Chief Operating Officer 27.0 13.0 X 368968 0 24080 Alan Lederman SVP, BUSINESS INTEL & TPA OPS 27.0 13.0 X 333962 0 17852 Victor Collymore Chief Medical Officer 27.0 13.0 X 297388 0 26766 Pam Sullivan VP, HR & Facilities 36.0 4.0 X 191639 0 21868 Stephen Swanson VP, Information Technology 40.0 0.0 X 213376 0 15637 Mike Evans VP, Customer Care Ops 27.0 13.0 X 220665 0 22103 Abie Castillo VP, Provider Services/Network 27.0 13.0 X 225222 0 36924 Lucy Sutphen Medical Director 27.0 13.0 X 308936 0 25714 Mel Yeck Project Manager II 40.0 0.0 X 246134 0 8811 Leslie Demme Program Director, Admin. 40.0 0.0 X 185374 0 23360 David DiGiuseppe Director of Medicare Strategy 36.0 4.0 X 172313 0 20967 Julie Keeffe Director, Exchange Strategy & 27.0 13.0 X 173146 0 12012 Marie Faulring Dir. of Financial Operations 29.0 11.0 X 170918 0 18021 4750475 0 341141 54 false true false ARCADIA SOLUTIONS LLC 20 BLANCHARD RD STE 10 BURLINGTON MA 018035155 SOFTWARE CONSULTING 2524617 PERKINS COIE LLP 1201 THIRD AVE SUITE 4800 SEATTLE WA 981013099 LEGAL CONSULTING 869719 TEK SYSTEMS INC 7437 RACE ROAD HANDOVER MD 21076 IT CONTRACTING 868558 MOLLY BROWN TEMPS INC 1300 114TH AVE SE STE 251 BELLEVUE WA 98004 OFFICE CONTRACTING 771273 GENERAL UI LLC 3417 EVANSTON AVE N SUITE 501 SEATTLE WA 98103 IT CONSULTING 716578 28 0 0 0 PREMIUM EARNED 900099 872740820 872740820 0 0 872740820 3906498 3906498 0 0 0 0 0 100661444 98500884 2160560 2160560 2160560 0 0 0 0 0 878807878 872740820 0 6067058 0 0 0 0 0 0 0 0 3863324 0 3863324 0 0 0 0 0 35381928 3130550 32251378 0 808541 99126 709415 0 0 0 0 0 2127180 216917 1910263 0 0 0 0 0 1225732 0 1225732 0 3552682 0 3552682 0 0 0 0 0 0 0 0 0 0 0 28923876 13117172 15806704 0 1750210 0 1750210 0 2047793 159474 1888319 0 512514 0 512514 0 0 0 0 0 3319638 0 3319638 0 493978 24000 469978 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6923203 26657 6896546 0 329709 10259 319450 0 MEDICAL AND HOSPITAL EXPENSE 751798105 751798105 0 0 TAXES, LICENSES AND FEES 15142758 0 15142758 0 COLLECTION AND BANK SERVICES 209739 0 209739 0 BOARDS, BUREAUS AND ASSOC. 154775 6222 148553 0 1798715 1798715 860364400 770387197 89977203 0 0 117624627 162072127 0 0 0 0 19408741 21677629 0 0 0 0 0 0 0 0 0 0 2187954 1035545 777481 1152409 172753035 185025348 0 0 0 0 0 0 3435365 6994099 313999249 376921612 187907631 239122874 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187907631 239122874 X 0 0 14738448 14738448 111353170 123060290 126091618 137798738 313999249 376921612 X 18443478 7356845 -14093203 X false true X true false 2187954 1035545 1152409 1152409 0 0 878807878 878807878 878807878 860364400 860364400 860364400 X X X true false false false false false false false false Lance Hunsinger Chief Executive Officer 475172 0 491500 0 17500 0 23000 0 5174 0 1012346 0 0 0 Wade J Harman Chief Legal Officer 227553 0 60891 0 0 0 17458 0 2668 0 308570 0 0 0 Stacy Kessel Chief Financial Officer 267768 0 74750 0 0 0 17072 0 1654 0 361244 0 0 0 Marilee K McGuire Chief Operating Officer 291289 0 77679 0 0 0 23000 0 1080 0 393048 0 0 0 Victor Collymore Chief Medical Officer 279888 0 0 0 17500 0 23000 0 3766 0 324154 0 0 0 Alan Lederman SVP, BUSINESS INTEL & TPA OPS 260141 0 73821 0 0 0 16772 0 1080 0 351814 0 0 0 Pam Sullivan VP, HR & Facilities 166016 0 25623 0 0 0 17500 0 4368 0 213507 0 0 0 Stephen Swanson VP, Information Technology 183872 0 29504 0 0 0 12963 0 2674 0 229013 0 0 0 Mike Evans VP, Customer Care Ops 190375 0 30290 0 0 0 21743 0 360 0 242768 0 0 0 Abie Castillo VP, Provider Services/Network 186082 0 31750 0 7390 0 31750 0 5174 0 262146 0 0 0 Lucy Sutphen Medical Director 141253 0 45712 0 121971 0 23000 0 2714 0 334650 0 0 0 Mel Yeck Project Manager II 184143 0 26143 0 35848 0 8511 0 300 0 254945 0 0 0 Leslie Demme Program Director, Admin. 160925 0 24449 0 0 0 23000 0 360 0 208734 0 0 0 David DiGiuseppe Director of Medicare Strategy 146869 0 25444 0 0 0 17500 0 3467 0 193280 0 0 0 Julie Keeffe Director, Exchange Strategy & 148784 0 24362 0 0 0 10481 0 1531 0 185158 0 0 0 Marie Faulring Dir. of Financial Operations 146544 0 24374 0 0 0 16839 0 1182 0 188939 0 0 0 SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENT IN 2013: MEL YECK - $35,848 LUCY SUTPHEN - $104,471 FORM 990, PART VI, LINE 6 DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS THE ORGANIZATION HAS 1 CORPORATE MEMBER, COMMUNITY HEALTH NETWORK OF WASHINGTON ("CHNW"), A RELATED 501(C)(4) TAX EXEMPT ENTITY. FORM 990, PART VI, LINE 7A DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS THE BOARD OF DIRECTORS OF THE SOLE CORPORATE MEMBER, CHNW, ELECTS THE BOARD OF DIRECTORS. EACH MEMBER OF THE BOARD OF DIRECTORS MUST MEET THE QUALIFICATIONS TO BE A CHNW BOARD. DURING 2013, ALL CHPW BOARD MEMBERS SERVED ON THE CHNW BOARD. FORM 990, PART VI, LINE 7B DESCRIPTION OF CLASSES OF PERSON AND DECISIONS REQUIRING APPROVAL THE FOLLOWING POWERS RELATED TO CHPW ARE RESERVED TO CHNW BY ITS BYLAWS: A) AMENDMENT TO THE ARTICLES OF INCORPORATION, B) AMENDMENT TO THE BYLAWS, C) REMOVAL OF ONE OR MORE DIRECTORS FROM THE BOARD, D) APPROVAL OF ARTICLES OF MERGER, E) APPROVAL OF THE SALE OR LEASE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF CHPW OTHER THAN IN THE ORDINARY COURSE OF BUSINESS, AND F) APPROVAL OF THE VOLUNTARY DISSOLUTION OF CHPW. FORM 990, PART VI, LINE 11B DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 THE 990 AND ALL REQUIRED SCHEDULES ARE REVIEWED BY THE DIRECTOR OF FINANCIAL REPORTING, CHIEF FINANCIAL OFFICER, CHIEF LEGAL OFFICER, AND CHIEF EXECUTIVE OFFICER. THE CHIEF FNANCIAL OFFICER THEN PRESENTS IT TO THE FINANCE COMMITTEE AND THE BOARD OF DIRECTORS FOR REVIEW BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, LINE 12C DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST ALL DIRECTORS, OFFICERS, AND SENIOR EMPLOYEES ARE REQUIRED TO ANNUALLY DISCLOSE POTENTIAL CONFLICTS OF INTEREST. WITH RESPECT TO BOARD MEMBERS, POTENTIAL CONFLICTS ARE DISCLOSED PRIOR TO DELIBERATIONS; IF AN ACTUAL CONFLICT EXISTS, THE INDIVIDUAL WITH THE CONFLICT WILL NOT PARTICIPATE AND IS ASKED TO LEAVE THE MEETING DURING FINAL DELIBERATIONS AND VOTE. EMPLOYEES ARE GOVERNED BY THE ORGANIZATION'S CONFLICT OF INTEREST POLICY; ACTUAL OR POTENTIAL CONFLICTS MUST BE DISCLOSED TO HUMAN RESOURCES DEPARTMENT OR CORPORATE COMPLIANCE OFFICER. THE COMPLIANCE OFFICER, IN COOPERATION WITH HUMAN RESOURCES, WILL REVIEW THE CONFLICT AND ADVISE THE EMPLOYEE WITH POTENTIAL CONFLICT CONCERNING ANY LIMITATIONS THEY MUST OBSERVE IN REGARDS TO THE CONFLICT OF INTEREST. FORM 990, PART VI, LINE 15A AND 15B OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN AT LEAST ANNUALLY, THE CHPW HUMAN RESOURCES DEPARTMENT REVIEWS COMPENSATION OF ALL EMPLOYEES (INCLUDING EMPLOYED OFFICERS AND KEY EMPLOYEES). THE CHPW HUMAN RESOURCES DEPARTMENT UTILIZES SEVERAL INDEPENDENT THIRD PARTY COMPENSATION SURVEYS TO MAKE RECOMMENDATIONS ABOUT EMPLOYED OFFICER AND KEY EMPLOYEE COMPENSATION. UTILIZING THAT INFORMATION, THE CHPW CEO SETS THE COMPENSATION FOR EMPLOYED OFFICERS AND KEY EMPLOYEES. THE CHPW CEO COMPENSATION IS SET BY THE EXECUTIVE COMMITTEE OF THE CHPW BOARD OF DIRECTORS BASED UPON INDEPENDENT THIRD PARTY COMPENSATION INFORMATION AND PROFESSIONAL OPINION. THE DELIBERATIONS AND APPROVAL OF CEO COMPENSATION ARE RECORDED IN THE EXECUTIVE COMMITTEE OR BOARD MINUTES. THIS PROCESS WAS LASTED COMPLETED IN 2013. FORM 990, PART VI, LINE 19 AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC COPIES OF GOVERNANCE DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE BY REQUEST MADE TO THE CORPORATE OFFICES AT 720 OLIVE WAY, SUITE 300 SEATTLE, WA 98101 OR BY FAXING A REQUEST TO (206) 521-8834. ALSO, THE STATUTORY AUDITED FINANCIAL STATEMENTS ARE POSTED ON THE OFFICE OF INSURANCE COMMISSIONER WEBSITE. FORM 990, PART VII BOARD COMPENSATION THE FOLLOWING INDIVIDUALS SERVE ON THE BOARD OF COMMUNITY HEALTH PLAN OF WASHINGTON (CHPW) IN CONNECTION WITH THEIR ROLES AS THE CEO OR EXECUTIVE DIRECTOR OF THE TAX-EXEMPT COMMUNITY HEALTH CENTER OR CLINIC (CHC) MEMBERS OF COMMUNITY HEALTH NETWORK OF WASHINGTON. THESE INDIVIDUALS DO NOT RECEIVE COMPENSATION FOR THE BOARD SERVICE; HOWEVER, CHPW PAYS THEIR RESPECTIVE CHC A STIPEND FOR SUCH SERVICE. - ANITA MONOIAN - BARBARA MALICH - BOB FERRELL - DAVID FLENTGE - DESIREE SWEENEY - DESMOND SKUBI - DIAN COOPER - JUAN CORDOVA - LINDA MCVEIGH - MARK SECORD - MICHAEL HASSING - PEGGY HOPKINS - SHEILA CHILSON - STEVEN CLARK - TERESITA BATAYOLA - THOMAS TROMPETER FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS CHANGE IN NONADMITTED ASSETS (1,693,203) ISSUANCE OF SURPLUS NOTE (12,400,000) ------------- TOTAL (14,093,203) COMMUNITY HEALTH NETWORK OF WASHINGTON 720 OLIVE WAY SUITE 300 SEATTLE WA 98101 911577184 HEALTHCARE WA 501(c)(4) NA false false false false false false false false false false false false true true true true true false true true