2013-11-13T14:39:34-06:00 2012-12-31 420714325 McGladrey LLP One South Wacker Suite 800 Chicago IL 60606 990 2012-01-01 382242827 HEALTH ALLIANCE PLAN OF MICHIGAN HEAL 3136648559 2850 WEST GRAND BOULEVARD DETROIT MI 48202 Ronald W Berry 3136648559 2013-11-13 1 Zachary A Fortsch P00052725 3126343400 2012 2016-02-24 21:20:13Z Ronald W Berry 2850 WEST GRAND BOULEVARD DETROIT MI 48202 2174413469 0 X www.hap.org X 1979 MI Provide access to quality health care coverage. 16 16 823 99 690134 31783 0 0 1783455812 1885558873 7326389 9387628 635231 817222 1791417432 1895763723 0 0 1627176604 1707495571 72321271 75975479 0 0 0 71554539 91114938 1771052414 1874585988 20365018 21177735 575301796 613973861 259829646 272357347 315472150 341616514 X To enhance the health and well-being of the lives we touch. 0 0 1845032167 1885558873 Health Alliance Plan (HAP) is a nonprofit, regional health plan based in Detroit that provides health coverage to individuals and companies. HAP is a subsidiary of the Henry Ford Health System, one of the nation's leading health care systems. A leader in personalized customer service, disease management and wellness programs, HAP partners with physicians, employers and community organizations to improve the health and well-being of the community.Participating Physicians and Ancillary Providers: HAP contracts with Michigan's leading healthcare providers to provide medical services to its members. Approximately 91 percent of HAP's revenue is paid to the contracted healthcare providers for administering care. More than 11,000 physicians affiliated with 52 hospitals administered healthcare to HMO members. HAP's robust provider networks include the leading Michigan doctors, hospitals and health systems: Beaumont, St. John/Providence, Henry Ford Health System, Genesys, McLaren and the University of Michigan. Statewide and national provider network solutions are available through strategic partnerships with Physicians Care network, CIGNA and NationCare for companies with multiple locations.HAP contracts with urgent care centers, pharmacies and ancillary providers to serve its membership. At the end of 2012, HAP's HMO membership enrollment was 342,264; HAP serviced 4,128,664 member months.Members worked with their chosen healthcare providers to maintain a healthy lifestyle or manage their chronic conditions. The following statistics reflect utilization for the HMO product: HAP HMO members incurred 17,057 hospital stay admissions in 2012 for medical/surgical procedures, and 1,854 hospital admissions for behavioral health-related issues. HAP and its providers encourage members to seek routine services and preventive health screenings to maintain their health and meet their personal health goals. The majority of these services are obtained in their physician offices. HAP spends a considerable amount of resources communicating with members and providing supportive health programs and resources to help them achieve sustainable healthy habits. Examples of member communications include:1) Personal Service Coordinators who are assigned to members during the first two years of membership to help them maximize their HAP coverage and navigate the healthcare system.2) State-of-the-art wellness tools to help members manage their health, such as the online health coaching software (iStrive for better health) and links on HAP's website (hap.org) to smoking cessation, stress reduction, weight loss programs, and others.3) Health and Wellness Programs:* Preventive Services HAP covers cancer screenings, physicals, flu shots and a variety of other services.* Worksite Wellness programs bring free or low-cost preventive services and health education to the workplace.* iStrive for better health provides online health coaching.* Weight Watchers discounts and HAP Weight WiseSM events promote lasting weight control.* Member friendly educational tools help members manage their plan benefits and their health. * Wellness programs and publications help members at every age and every stage of life: HAP Wise Woman, LiveWell: Mid-Life and Prime Time Living. * Global Emergency Services and Assist America - Urgent care and emergency services are covered worldwide. Our contract with Assist America provides a full range of emergency medical services to help with difficulties while traveling 100+ miles away from home, or in another country.* Care for Chronic Conditions - HAP's CareTrackTM program matches chronically ill members with the resources they need to reach their personal health goals, from personalized health information to inspirational nurse health coaching.* Behavioral Health - Specially trained social workers, psychologists and counselors provide integrated behavioral and medical disease management services to members with mental health and substance abuse conditions.* Pharmacy Initiatives - HAP pharmacists ensure members have access to safe, effective medications.* Medication Therapy Management Program - HAP pharmacists counsel seniors with chronic conditions and their physicians to make taking multiple medications safer and more effective.HAP is a full service health maintenance organization with distinct product portfolios:* Group Plans - PPO, EPO and HMO; Health Engagement programs offer employees incentives to adopt a healthier lifestyle.* Personal plans - HAP Personal Alliance PPO, HSA and Short-Term health plans are for individuals and families not covered through employer health insurance.* Medicare Solutions - HAP Medicare Solutions offer PPO and HMO plans, prescription drug plans, and Medicare Supplement plans for individuals and employer-sponsored retirees.Community Stewardship: After learning that Detroit residents were not taking advantage of available aquatic recreational opportunities, HAP launched a free water aerobics program - Senior Splash Bash & Moms in Motion - at four Detroit recreation centers. The program has since been expanded to 10 locations in our service area. Since 2005, the program has expanded significantly. Classes are open to the public - not just HAP members. Boots for Kids: HAP's East Central Region office in Flint launched the "Boots for Kids" winter boot drive in 2008 to prevent local children from facing a bitter cold winter without a warm pair of boots to protect their feet. In 2011, HAP developed a program guide, promotional videos and social media tactics to boost community support. In 2012, Boots for Kids collected more than 850 pairs of boots ($22,000 estimated value) and the mumber of community partners grew to more than 35.Ready, Set, Cook: The program, Ready, Set, Cook, teaches children ages 8-14 how to use healthy, simple recipes and inspires the whole family to eat healthier, use fewer processed foods and eat out less often - improving their health and saving money while doing it. In 2012, the program was implemented at 4 locations, with 487 participants.In 2012, HAP partnered with National Kidney Foundation of Michigan to bring Enhance Fitness classes to the community in three community centers in the Metro Detroit area. This is a free physical activity program geared toward improving the overall functional fitness and well-being of older adults. A total of 261 people participated in the program in 2012. START! Heart Walk (Detroit): In 2012, 57 HAP volunteers raised more than $30,000 to support the American Heart Association's efforts to fight heart disease and stroke.Bowling for Kids' Sake (Sterling Heights): In 2012, 53 HAP volunteers raised nearly $15,000 in support of the Big Brothers Big Sisters of Metropolitan Detroit's efforts to recruit, enroll and pair volunteers with children who need them most. Walk to End Alzheimer's (Royal Oak): In 2012, 15 HAP employees and family members participated in the 21st Annual Walk to End Alzheimer's, raising nearly $10,000 to support progress in prevention, treatment and an eventual cure, as well as those affected by the disease.March of Dimes Walk for Babies (Detroit): HAP sponsored the 2012 March of Dimes Walk for Babies at Wayne State University to support community programs that help mothers have healthy, full-term pregnancies and fund research to find answers to the problems that threaten babies. In 2012, 59 HAP volunteers raised more than $15,000.Annual Holiday Drive: In 2012, HAP employees once again exhibited the true spirit of the season by filling approximately 18 boxes of art supplies, games and miscellaneous items for the Neighborhood Services Organization. HAP departments also sponsor families through organizations like Orchard's Children's Services and collect food and other items for organizations such as Forgotten Harvest.Michigan Colleges Foundation Scholarship: The Health Alliance Plan provided sponsorship to Michigan Colleges Foundation who used the money to provide scholarships to students from Wayne, Oakland or Macomb counties enrolled in nursing, clinical laboratory science, health-fitness, dietetics or physical therapy coursework at Madonna University and Marygrove College.19 HAP employees served as mentors at Cody High School in conjunction with Big Brothers Big Sisters.4 HAP employees served as mentors at Jalen Rose Academy in conjunction with Winning Futures.20 HAP employees packed nearly 25,000 lbs of food at Gleaners Community Food Bank.55 HAP employees planted 30 trees in Detroit as part of the Greening of Detroit initiative.12 HAP Employees assisted with Jr. Achievement Career Day.HAP employees collected a total of 1,075 assorted canned goods/boxes during our annual Food Drive. 1845032167 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 0 1 8412 0 1 823 1 1 1 0 0 0 0 0 0 0 X 16 16 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Ronald W Berry 3136648559 2850 West Grand Boulevard Detroit MI 48202 Susan Wells 1.00 X 160 0 0 Marvin Beatty 1.00 X 206 0 0 Lauren B Foster CPA 1.00 X 0 0 0 Robin Scales-Wooten 1.00 X 228 0 0 Jackie Martin 1.00 4.00 X X 160 0 0 Rebecca R Smith 1.00 X 0 0 0 William A Conway MD 1.00 61.00 X 0 561006 50077 Nancy Schlichting 5.00 63.00 X 0 3257803 51202 William R Alvin 55.00 6.00 X X 0 943243 145959 Cindy Bala-Brusilow 1.00 X 0 0 0 Shari L Burgess 1.00 X 0 0 0 Joyce V Hayes Giles 1.00 X 0 0 0 Jamie C Hsu Ph D 1.00 X 160 0 0 Kirk J Lewis 1.00 X 226 0 0 Sandra A Cavette 1.00 X 0 0 0 Marquerite S Rigby 1.00 X 0 0 0 Linda Ewing 1.00 X 0 0 0 Harvey Hollins III 1.00 X 0 0 0 Ronald W Berry 60.00 X 518564 0 40579 Irita Matthews 50.00 X 174143 0 29071 Jeanne M Dunk 60.00 X 336426 0 33588 Naim Munir 60.00 X 623336 0 41431 Christopher Pike 60.00 X 396286 0 35077 Mary Ann Tournoux 60.00 X 417848 0 37004 Derick Adams 60.00 X 237154 0 35340 Howard M Flasch 60.00 X 297933 0 68255 Balakrishna Pai 50.00 X 353359 0 58352 Karen Wintringham 50.00 X 301334 0 46683 John Loomis 50.00 X 286668 0 35213 Todd Hutchinson 50.00 X 284714 0 33058 Mark Hall 50.00 X 284330 0 40395 Randy Walker 0.00 50.00 X 0 365304 50527 Maurice McMurray 0.00 X 202665 0 0 4715900 5127356 831811 131 1 1 0 Accenture LLP PO Box 70629 Chicago IL 60673 Software support & consulting 36556491 Patricia N Harrison 24416 Crocker Blvd Clinton Twp MI 48036 Advertising 5954008 RCG Global Services Inc PO BOX 822581 Philadelphia PA 19182 Software support & consulting 4787524 The Trizetto Group Inc 6061 S Willow Dr Greenwood Village CO 80111 Consulting services 3912981 Brian Unlimited Distribution Company 13700 Oakland Ave Highland Park MI 48203 Billing and documentation services 3136712 108 Health Care Premiums 524114 1874381211 1874381211 Health Ins Claims Asse 624110 11177662 11177662 1885558873 5371170 5371170 282640049 26155 278562585 87161 4077464 -61006 4016458 4016458 Medical Mgt. Income 900099 667378 667378 Misc Revenue 900099 127088 127088 Unrelated Membership I 541900 22756 22756 817222 1895763723 1885558873 690134 9514716 1707495571 1707495571 3322035 2120384 1201651 202665 202665 55451898 50035607 5416291 6340956 5451252 889704 6186451 5318426 868025 4471474 3820347 651127 805654 805654 212238 212238 612194 612194 3180438 3180438 10415899 10377671 38228 5900793 5874771 26022 29919540 29918291 1249 2512465 2006720 505745 522117 430064 92053 266220 169755 96465 469742 469742 11436846 9648260 1788586 Physicians Care Health 650319 650319 24210473 8534291 15676182 1874585988 1845032167 29553821 0 -293307 383570 103442183 202141701 55710269 55901225 2742112 3105872 120743346 60749811 33708363 59993535 251587169 154639704 110105187 120384602 9475608 8598706 8824212 8824946 575301796 613973861 36091189 35670475 14759302 16904541 208979155 219782331 259829646 272357347 X 315472150 341616514 315472150 341616514 575301796 613973861 X 21177735 -598593 5565222 X 0 1 X 1 0 380336 380336 4901920 3200064 1701856 8618166 6549342 2068824 24376145 19190228 5185917 82466779 31810177 50656602 59993535 120384602 C 120384602 Medical Claims 142736787 Capital Lease 44615381 Retiree Benefits 1563539 Pension 30866624 219782331 X Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: HAP is an entity described under Internal Revenue Code Section 501(c)(4) and as such is exempt from federal and state income taxes. Any income not substantially related to the organization's exempt purpose may be considered unrelated business income (UBI) under IRC Section 511 and, as such, subject to tax at normal corporate rates. HAP has concluded that there are no material uncetain tax positions as of December 31, 2012 and 2011. X 1 1 1 1 0 0 0 0 0 0 0 William A Conway MD 0 478866 0 64954 0 17186 0 31295 0 18782 0 611083 0 0 Nancy Schlichting 0 1371098 0 1157905 0 728800 0 28796 0 22406 0 3309005 0 0 William R Alvin 0 553929 0 365303 0 24011 0 132334 0 13625 0 1089202 0 0 Ronald W Berry 359018 0 119162 0 40384 0 19400 0 21179 0 559143 0 0 0 Irita Matthews 142387 0 30767 0 989 0 11279 0 17792 0 203214 0 0 0 Jeanne M Dunk 253007 0 81835 0 1584 0 15528 0 18060 0 370014 0 0 0 Naim Munir 389141 0 231573 0 2622 0 20837 0 20594 0 664767 0 0 0 Christopher Pike 284096 0 94550 0 17640 0 16263 0 18814 0 431363 0 0 0 Mary Ann Tournoux 305993 0 95325 0 16530 0 19588 0 17416 0 454852 0 0 0 Derick Adams 196091 0 38899 0 2164 0 12403 0 22937 0 272494 0 0 0 Howard M Flasch 230454 0 61920 0 5559 0 48184 0 20071 0 366188 0 0 0 Balakrishna Pai 248619 0 69856 0 34884 0 41900 0 16452 0 411711 0 0 0 Karen Wintringham 235156 0 62717 0 3461 0 26900 0 19783 0 348017 0 0 0 John Loomis 235362 0 49113 0 2193 0 31900 0 3313 0 321881 0 0 0 Todd Hutchinson 232118 0 52080 0 516 0 11730 0 21328 0 317772 0 0 0 Mark Hall 180289 0 102450 0 1591 0 30397 0 9998 0 324725 0 0 0 Randy Walker 0 293290 0 65951 0 6063 0 31296 0 19231 0 415831 0 0 Maurice McMurray 0 0 0 0 202665 0 0 0 0 0 202665 0 0 0 Part I, Line 1a Part I - 1a: Tax indemnification and gross-up payments: 6 Directors received taxable income for entertainment expenses paid by the organization associated with their spouse/family attendance at a Board of Directors retreat. Part I - 4a: Maurice McMurray - 52 weeks (Severance) .............. 202,665 Part I - 4b: Certain members of the organization's senior leadership team participate in a supplemental retirement program (SERP 457(f) Plan) that results in reportable taxable income as the benefits accrue, rather than as they are paid. It is an element of the plan design to absorb the advance tax impact of these plans for the participants. In such cases the related amounts are reported as taxable income to the individual and included in the determination of reasonable compensation. The employee that received this taxable benefit is also an officer of the company. 4b: Ronald Berry - SERP (vested - $21,839) Naim Munir MD - SERP (non-vested) Jeanne M Dunk - SERP (non-vested) Christopher Pike - SERP (non-vested) Mary Ann Tournoux - SERP (non-vested) Derick Adams - SERP (non-vested) Howard Flasch - SERP (non-vested) Part I, Line 3 The Chief Executive Officer for Health Alliance Plan is an employee of Henry Ford Health System, HAP's parent company. Henry Ford Health System has a Compensation Committee of the Board of Trustees consisting of all external trustees. The committee meets throughout the year and is charged with the approval of the organization's overall compensation and benefit programs as well as the specific review and approval of the compensation of certain employees including the Chief Executive Officer of HAP. The committee directly engages an independent compensation advisor to assist with this process. The process includes evaluation of the individual's performance, utilization of compensation studies of similarly situated positions as well as comparisons to compensation as reported by other health care organizations. The reasonableness of compensation is evaluated based upon these and other factors. Walgreens Nancy Schlichting - Director serveson the board of Walgreens 27011804 Pharmacy Claim Payments 0 Form 990, Part VI, Section A, line 6 HAP is a nonprofit member corporation. The responsibility for the overall governance of the corporation is shared between the Member and the Board of Directors. HAP's sole member is Henry Ford Health System (HFHS), a 501(c)(3) corporation. The President and CEO of Henry Ford Health System serves on the HAP Board of Directors. The President and CEO of HAP, who is also an employee of HFHS, serves on the HAP Board of Directors. Form 990, Part VI, Section A, line 7a The HAP Board of Directors is comprised of sixteen Directors. Two Directors are ex officio Directors: President and CEO of the Member and the President and CEO of HAP (also an employee of the Member). Six Directors are elected by the subscribers of HAP. Nine Directors are appointed by the Member's Board of Trustees. The President of HAP may appoint a Quality Officer from HFHS. As indicated above, the Henry Ford Health System may remove the President and CEO of HAP, and may remove any of the appointed Directors, with the input of the HAP Board of Directors. The Member approves the recommendations of the HAP Board of Directors regarding the appointment/removal of the HAP President and CEO, amendments to the articles of incorporation and by-laws, the budget, mergers and acquisitions, potential Directors. Form 990, Part VI, Section A, line 7b The Member has the following reserved powers under the HAP By-laws: A. Appoint Chairperson of the HAP Board of Directors. B. Adopt agreement of merger or consolidation, or approve sale, lease or exchange of Corporation's property and assets. C. Approve the transfer of assets to other organizations or individuals if sum exceeds 5% of Corporation's total assets. D. Admit person/entity as new Member or terminate Member's membership. E. Amend HAP By-laws. F. Appoint/remove President of Corporation. G. Dissolve Corporation or revoke dissolution of Corporation. H. Approve capital and operating budgets. Form 990, Part VI, Section B, line 11 The process the organization uses to review Form 990 prior to filing with the IRS: Prior to submission of the IRS Form 990, Health Alliance Plan provided the Form 990 to the Finance Committee of the HAP Board of Directors for their review. All the voting members of the Board received a complete copy of the Form 990 prior to its filing and received a written report from the Finance Committee on the results of the committee's review of the Form 990 at the October Board meeting. Form 990, Part VI, Section B, line 12c The process for regularly and consistently monitoring and enforcing compliance with the conflict of interest policy for all directors and officers: HAP has a robust compliance program. The program requires all directors and officers of HAP to complete a conflict of interest document. The documents are reviewed and maintained by the Compliance Officer. In addition, HAP is required to submit Board disclosure statements to the Michigan Office of Finance and Insurance Regulations. Thus, on an annual basis, all Directors, Officers, and key employees, and others subject to IRS Form 990 reporting are requested to complete the Conflict of Interest Questionnaire. In addition, they are provided a copy of the policy. The Compliance Officer tracks receipt of the Conflict of Interest Questionnaire and follows-up on any identified conflicts. All conflicts are reported to the HAP Board of Directors' Audit Committee, and the President and CEO for review and resolution. All Directors and Officers are required, under the policy, to report to the Compliance Officer any conflicts that may arise during the year. Violations of the Conflicts of Interest Policy - The board determines if the member has in fact failed to disclose an actual or possible conflict of interest, it shale take appropriate disciplinary and corrective action. Form 990, Part VI, Section B, line 15 Part VI Section B, Question 15a & b The Organization is an affiliate of Henry Ford Health System (HFHS) who has the responsibility to oversee the compensation practice of the Organization. HFHS has a compensation committee of the board of trustees consisting of all external trustees. They meet periodically throughout the year. They are charged with approval of the Organization's overall compensation and benefit programs as well as the specific review and approval of the compensation of certain employees including the CFO, all officers and key employees of the Organization. They directly engage an independent compensation advisor to assist with this process. The process includes evaluation of the individual's performance, utilization of compensation studies of similarly situated positions, as well as comparisons to compensation as reported by other health care organizations. The reasonableness of compensation is evaluated based upon these and other factors. The committee also reviews the compensation disclosure to be made on Form 990 in advance of filing. Form 990, Part VI, Section C, line 19 The process of making governing documents, conflict of interest policy and financial statements available to the public: HAP is committed to the idea of transparency. Therefore, HAP consistently and regularly discloses most information to our providers, consumers, and employer groups. HAP's governing documents and conflict of interest policy are available on the internet. HAP Bylaws, Articles of Incorporation, and financial statements are submitted to the Michigan Office of Financial and Insurance Regulations. They are available to the public through a Freedom of Information Act request to this agency. In addition, HAP will provide its Form 990 to anyone who requests to view it or to receive a copy of the Form 990. The Form 990 is also available for viewing on the following website: www.guidestar.org Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: HAP Pension Adjustment -5,264,641. Unrelated Income from Limited Liability Partnership -22,756. Noncontrolling interest in ASR 3,889,100. ASR controling Income adjustment 90,849. HPI Pension Adjustment -1,096,601. Alliance Health & Life Insurance Co. Net Income 1,960,451. Midwest Health Plan, Inc. Net Income 6,941,071. Administration Systems Research Corporation Net Income 765,699. HAP Preferred Net Income 1,324,898. Midwest Health Plan Inv. Adj. -1,567,000. PCHM Net Income -667,378. Dividends Paid - Administration Systems Research Corp. -521,000. PCHM Expenses -650,319. Administration Systems Research Corporation Non-controlling Net Income 382,849. Physicians Care Health Management 2850 W Grand Blvd Detroit MI 48202 208423038 Medical Case Management MI 337378 0 Health Alliance Plan Henry Ford Health System One Ford Place Detroit MI 48202 381357020 Healthcare Service Provider MI 501(c)(3) 3 N/A 0 Henry Ford Macomb Hospital Corporation One Ford Place Detroit MI 48202 382947657 Healthcare Service Provider DE 501(c)(3) 3 Henry Ford Health System 1 Henry Ford Health System Foundation One Ford Place Detroit MI 48202 237383042 Supporting Organization MI 501(c)(3) 11a-Type 1 Henry Ford Health System 1 Henry Ford Wyandotte Hospital 2333 Biddle Ave Wyandotte MI 48192 382791823 Healthcare Service Provider MI 501(c)(3) 3 Henry Ford Health System 1 HFHS Self Funded Liability One Ford Place Detroit MI 48202 386553031 Malpractice Insurance MI 501(c)(4) n/a Henry Ford Health System 1 Downriver Center for Oncology One Ford Place Detroit MI 48202 383193008 Healthcare Service Provider MI 501(c)(3) 3 Henry Ford Health System 1 Henry Ford Continuing Care One Ford Place Detroit MI 48202 382433285 Nursing Homes MI 501(c)(3) 9 Henry Ford Health System 1 HFII Corporation One Ford Place Detroit MI 48202 900840304 Scientific Research MI 501(c)(3) 7 Henry Ford Health System 1 Northwest Detroit Dialysis 30100 Telegraph Bingham Farms MI 48025 383232668 Operate Dialysis Clinic MI Henry Ford Health System Related 0 0 Dialysis Partners of NW Ohio 30100 Telegraph Bingham Farms MI 48025 341877956 Operate Dialysis Clinic OH Henry Ford Health System Related 0 0 Macomb Regional Dialysis Centers 16151 Nineteen Mile Rd Clinton Township MI 48038 260423581 Operate Dialysis Clinic MI Henry Ford Health System Related 0 0 Alliance Health and Life Insurance Company 2850 West Grand Boulevard Detroit MI 48202 383291563 Health Insurance MI Health Alliance Plan C 1960451 62745994 1.00000 1 HAP Preferred Inc 2850 West Grand Boulevard Detroit MI 48202 382513504 Provider Network Leasing MI Health Alliance Plan C 1324898 8089316 1.00000 1 Sha Realty Inc One Ford Place Detroit MI 48202 381378121 Recreational Service - Golfing MI Henry Ford Health System Foundation C 1 Fairlane Health Services 30100 Telegraph Bingham Farms MI 48025 382565235 Healthcare Management MI Henry Ford Health System C 1 Horizon Properties Inc One Ford Place Detroit MI 48202 382679527 Real Estate - Lessor Buildings MI Detroit Osteopathic Hospital Corp C 1 First Optometry Eye Care Centers Inc 655 W13 Mile Rd Madison Heights MI 48071 382299059 Franchising Eye Care Centers MI Henry Ford Health System C 1 First Optometry Vision Plans Inc 655 W13 Mile Rd Madison Heights MI 48071 382594841 Vision Care Plans MI Henry Ford Health System C 1 Onika Insurance Ltd First Carribean House Grand Cayman CJ Captive Insurance CJ Henry Ford Health System C 1 Midwest Health Plan Inc 4700 Schaefer Rd Suite 340 Dearborn MI 48126 383123777 Health Insurance MI Health Alliance Plan C 6941071 140752000 1.00000 1 Administration Systems Research Corporation International 2850 West Grand Boulevard Detroit MI 48202 382651185 Third Party Administrator MI Health Alliance Plan C 765699 1983191 0.66670 1 HAP Community Alliance 2850 West Grand Boulevard Detroit MI 48202 270449055 Health Maintenance Organization MI Health Alliance Plan C 0 Henry Ford Physician Network one Ford Place detroit MI 48202 320306774 Physician Network MI Henry Ford Health System C 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 HAP Preferred Inc Q 4996939 Fair market value Alliance Health and Life Insurance Company Q 19584008 Fair market value HAP Preferred Inc P 2402418 Fair market value Henry Ford Wyandotte M 31064485 Fair market value Henry Ford Macomb Hospital Warren M 4566 Fair market value Henry Ford Macomb Hospital M 45653019 Fair market value First Optometry M 44667 Fair market value Henry Ford Physician Network M 2355644 Fair market value SCHEDULE R, PART V, LINE 1D & 1E: The organization is a member of the Henry Ford Health System Obligated Group. Members of the Obligated Group are jointly and severally liable for outstanding obligations issued under the Bond Master Indenture. SCHEDULE R, PART V, LINE 2, COL. C: All transactions involved cash transfers at the time of services rendered or received. Therefore, the cash value at the time of the transactions is considered the fair market value.