2013-10-23T10:49:27-05:00 2012-12-31 861065772 DELOITTE TAX LLP 655 WEST BROADWAY SUITE 700 SAN DIEGO CA 921018590 990 2012-01-01 731729007 SCAN HEALTH PLAN ARIZONA SCAN 5629895100 3800 KILROY AIRPORT WAY NO 100 LONG BEACH CA 908065616 WALTER RANDY STONE 5629895100 2013-10-22 1 DIANA J MCCUTCHEN P00545657 6192326500 2012 2016-03-07 17:11:31Z CHRISTOPHER WING 3800 KILROY AIRPORT WAY NO 100 LONG BEACH CA 908065616 118574214 0 X WWW.SCANHEALTHPLAN.COM/ARIZONA/MEDICARE/ X 2006 AZ TO SERVE AND TO IMPROVE THE LIVES OF THE FRAIL, ELDERLY AND DISABLED RESIDENTS OF ARIZONA. 3 0 200 0 0 0 0 0 164040421 118465893 241837 108321 0 0 164282258 118574214 0 0 0 0 2851978 11594273 0 0 0 158698955 139828462 161550933 151422735 2731325 -32848521 68565984 64810167 91156327 92250262 -22590343 -27440095 X TO SERVE AND IMPROVE THE LIVES OF THE FRAIL, ELDERLY AND DISABLED RESIDENTS OF ARIZONA BY PROVIDING MEDICAL AND PHARMACY SERVICES, COORDINATED CARE, SOCIAL SERVICES AND OTHER SERVICES TO A GERIATRIC AND DISABLED POPULATION THAT IS UNDERSERVED AND AT RISK. 0 0 133725970 118465893 SCAN HEALTH PLAN ARIZONA, A MEDICARE ADVANTAGE CONTRACTOR, IS A NON-PROFIT MANAGED CARE ORGANIZATION THAT WAS CREATED TO SERVE THE HEALTH CARE AND INDEPENDENCE NEEDS OF THE SENIOR AND PHYSICALLY DISABLED CITIZENS OF MARICOPA AND PIMA COUNTIES, ARIZONA. THE MISSION OF SCAN HEALTH PLAN ARIZONA IS TO FIND INNOVATIVE WAYS TO ENHANCE THE BENEFICIARIES' ABILITY TO MANAGE THEIR HEALTH AND EXERT CONTROL OVER WHERE AND HOW THEY LIVE. WE WILL ACHIEVE THAT MISSION BY DEVELOPING PARTNERSHIPS THAT ALLOW US TO DELIVER THE RIGHT HEALTH CARE, IN THE RIGHT SETTING, AND AT THE RIGHT COST WHILE MAXIMIZING THE MEMBERS' ABILITY TO REMAIN AS INDEPENDENT AS POSSIBLE. OUR GOAL IS TO BECOME THE LEADING GERIATRIC AND PHYSICALLY DISABLED HEALTH MANAGEMENT ENTERPRISE IN MARICOPA AND PIMA COUNTIES.SCAN HEALTH PLAN ARIZONA BEGAN PROGRAM OPERATIONS AS A MEDICARE ADVANTAGE CONTRACTOR EFFECTIVE JANUARY 1, 2007. IT IS RESPONSIBLE FOR ARRANGING AND MONITORING THE FULL RANGE OF MEDICARE HEALTH SERVICES FOR PLAN ENROLLEES. THE PLAN BEGAN OFFERING A MEDICARE ADVANTAGE SPECIAL NEEDS PLAN (SNP) FOR BENEFICIARIES WHO ARE DUALLY ELIGIBLE AND ENROLLED IN BOTH THE MEDICARE AND ALTCS PROGRAMS. BEGINNING JANUARY 1, 2009, THE PLAN EXPANDED ITS MEDICARE ADVANTAGE PARTICIPATION TO OTHER MEDICARE BENEFICIARY POPULATIONS, THROUGH A MEDICARE ADVANTAGE PRESCRIPTION DRUG (MAPD) PLAN.IN JANUARY 2008 SCAN LAUNCHED THE SCAN CONNECTIONS COMMUNITY RESOURCE CENTER DESIGNED TO LINK SCAN MEMBERS, THEIR CAREGIVERS AND OTHERS IN THE MARICOPA COUNTY COMMUNITIES WITH KNOWLEDGEABLE STAFF WHO CAN ASSIST IN NAVIGATING A COMPLEX HEALTH CARE SYSTEM. THE RESOURCE CENTER STAFF BUILD BRIDGES INTO OTHER COMMUNITY ORGANIZATIONS, GOVERNMENTAL AGENCIES AND HEALTH ADVOCACY GROUPS TO PROVIDE TO THE COMMUNITY HEALTH EDUCATION AND SUPPORT SERVICES FOCUSED ON GERIATRIC, CHRONIC ILLNESS AND PHYSICALLY DISABLED CHALLENGES. SERVICES AND RESOURCES ARE PROVIDED AT THE SCAN CONNECTIONS RESOURCE CENTER IN SCAN'S OFFICE AND AT REMOTE COMMUNITY SITES.SCAN HEALTH PLAN ARIZONA HAS GROWN FROM NO MEMBERSHIP AT DECEMBER 31, 2006 AND CURRENTLY SERVES MORE THAN 12,409 ENROLLEES. THE ADDITION OF THE SCAN CLASSIC AND SCAN CONNECTIONS PROGRAMS ALLOW SCAN PERSONNEL, ESPECIALLY THE CASE MANAGEMENT TEAM, TO MORE EFFECTIVELY COORDINATE THE NEEDED HEALTH CARE SERVICES REQUIRED BY SCAN MEMBERS. FROM THE START OF OPERATIONS, SCAN HEALTH PLAN ARIZONA HAS DEVOTED NEARLY 100% OF ITS REVENUE TO THE DIRECT PROVISION OF HEALTH CARE, HOME AND COMMUNITY BASED SERVICES AND LONG TERM CARE RESIDENTIAL SERVICES. THIS REPRESENTS MORE THAN $943 MILLION OF DIRECT CARE SERVICES FOR THESE MEDICARE AND MEDICAID ENROLLEES. OF THE TOTAL AMOUNT PAID FOR MEDICAL AND RESIDENTIAL SERVICES, APPROXIMATELY 29.3% WAS DIRECTED TO LONG TERM CARE RESIDENTIAL SERVICE PROVIDERS, 18.7% WAS DIRECTED TO HOME AND COMMUNITY BASED SERVICE PROVIDERS, AND 49.8% WAS DIRECTED TO OTHER MEDICAL SERVICE PROVIDERS AND THE REMAINING 2.3% WAS DIRECTED TO CASE MANAGEMENT COORDINATION SERVICES. 133725970 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 3307 0 1 200 1 0 0 0 0 0 0 0 0 0 0 X 3 0 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 AZ X VIRGINIA HAVAI 5629895100 3800 KILROY AIRPORT WAY LONG BEACH CA 90806 CHRISTOPHER WING 3.00 37.00 X X 0 891744 109099 DOUGLAS JAQUES 3.00 37.00 X X 0 453972 88308 ELIZABETH RUSSELL 30.00 10.00 X X 0 1100125 100061 WALTER R STONE 3.00 37.00 X 0 443528 63696 DAVE FIRDAUS 30.00 10.00 X 281568 0 31511 RAYMOND E COGEN 30.00 10.00 X 289898 0 10313 REBECCA LEARNER 3.00 37.00 X 0 607575 25491 JOEY ZEPEDA 27.00 13.00 X 346662 0 32012 RICHARD PEITZMEIR 40.00 X 209610 0 24081 WENDY J KARSTEN 30.00 10.00 X 163871 0 7748 JANINE ROUMAIN 30.00 10.00 X 145307 0 4289 TINA GRAHAM 17.00 23.00 X 93539 103026 11920 1530455 3599970 508529 9 0 1 0 EXPRESS SCRIPTS INC 21653 NETWORK PLACE CHICAGO IL 606731216 MEDICAL SERVICES 21184378 SCOTTSDALE HEALTHCARE HOSPITALS PO BOX 29682 PHOENIX AZ 850389682 MEDICAL SERVICES 5281766 JOHN C LINCOLN NORTH MOUNTAIN 250 E DUNLAP AVE PHOENIX AZ 85020 MEDICAL SERVICES 4709959 CATHOLIC HEALTHCARE WEST FILE 56765 LOS ANGELES CA 900746765 MEDICAL SERVICES 4704006 BANNER HEALTH 525 W BROWN RD 428 MESA AZ 85201 MEDICAL SERVICES 3771258 171 MEDICARE PREMIUM 900099 118465893 118465893 118465893 108321 108321 118574214 118465893 0 108321 1682699 1682699 7937211 5388241 2548970 455464 208851 246613 859135 562475 296660 659764 400383 259381 8175964 1140880 7035084 49393 49393 51520 51520 19000 19000 3095126 517451 2577675 1760833 4179 1756654 136110 15884 120226 5290 5290 430954 753 430201 167855 48582 119273 36991 12838 24153 177342 121677 55665 MEDICAL SERVICES FOR EL 125221300 125221300 MANAGEMENT RECRUITMENT 146673 3481 143192 TELECOMMUNICATIONS 93332 41353 51979 OFFICE EQUIPMENTS 90994 8505 82489 169785 29137 140648 151422735 133725970 17696765 0 57821209 54055661 4559 3990162 4978074 38920 122882 2003498 1830983 338208 172515 5125006 5156096 1252479 320380 68565984 64810167 40320084 41732906 509309 288952 50326934 50228404 91156327 92250262 X -22590343 -27440095 0 0 -22590343 -27440095 68565984 64810167 X -32848521 -1231 28000000 X 0 1 X 1 0 883637 883637 0 1119861 947346 172515 172515 INVESTMENT IN SCAN LONG TERM CARE 3500000 C OTHER RESTRICTED INVESTEMENTS 1656096 C 5156096 DEFERRED COMPENSATION 228404 SURPLUS NOTE PAYABLE 50000000 50228404 PART X, FIN 48 FOOTNOTE TO FINANCIAL STATEMENTS: FIN 48 (ASC 740) WAS ADOPTED BY THE ORGANIZATION DURING THE YEAR ENDED DECEMBER 31, 2009. THERE HAS BEEN NO LIABILITY FOR UNCERTAIN TAX POSITIONS RECORDED ON THE FINANCIAL STATEMENTS FOR THE CURRENT YEAR. X 1 1 1 1 1 0 0 0 0 0 0 CHRISTOPHER WING 0 594534 0 276598 0 20612 0 88160 0 20939 0 1000843 0 0 DOUGLAS JAQUES 0 312622 0 122575 0 18775 0 45854 0 42454 0 542280 0 0 ELIZABETH RUSSELL 0 365361 0 309240 0 425524 0 75235 0 24826 0 1200186 0 0 WALTER R STONE 0 347350 0 73977 0 22201 0 43210 0 20486 0 507224 0 0 DAVE FIRDAUS 240618 0 27547 0 13403 0 7431 0 24080 0 313079 0 0 0 RAYMOND E COGEN 270814 0 0 0 19084 0 1481 0 8832 0 300211 0 0 0 REBECCA LEARNER 0 100080 0 37133 0 470362 0 17500 0 7991 0 633066 0 145843 JOEY ZEPEDA 125680 0 32476 0 188506 0 17005 0 15007 0 378674 0 0 0 RICHARD PEITZMEIR 173543 0 17327 0 18740 0 14169 0 9912 0 233691 0 0 0 WENDY J KARSTEN 135639 0 20000 0 8232 0 0 0 7748 0 171619 0 0 0 TINA GRAHAM 58855 94442 34507 0 177 8584 6535 3841 737 807 100811 107674 0 0 PART I, LINE 1A SIGNIFICANT OTHERS' OF CERTAIN SCAN GROUP, SCAN HEALTH PLAN AND SCAN ARIZONA EXECUTIVES ATTENDED A COMPANY BUSINESS EVENT IN 2012, AT THE COMPANY'S REQUEST, FOR THE BUSINESS PURPOSE OF CREATING DEEPER AND MORE PRODUCTIVE RELATIONSHIPS BETWEEN SCAN AND IMPORTANT SCAN THIRD PARTY BUSINESS PARTNERS. SINCE THE COMPANY REQUESTED THAT THE SCAN SIGNIFICANT OTHERS ATTEND FOR THE PURPOSE OF ACHIEVING A COMPANY BUSINESS OBJECTIVE, THE COMPANY REIMBURSED THE TRAVEL EXPENSES OF THOSE COMPANIONS. PART I, LINE 3 COMPENSATION FOR THE PRESIDENT WAS ESTABLISHED AND PAID BY A RELATED ORGANIZATION. THE RELATED ORGANIZATION USED THE FOLLOWING TO ESTABLISH THE PRESIDENT'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) FORM 990 OF OTHER ORGANIZATIONS; (4) WRITTEN EMPLOYMENT CONTRACTS; (5) COMPENSATION SURVEY OR STUDY; (6) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINES 4A-C PART I, LINES 4A-C: 4A. DURING 2012, THE EMPLOYMENT RELATIONSHIP WITH ELIZABETH RUSSELL, PRESIDENT SOUTHWEST REGION ENDED. THE COMPANY NEGOTIATED AND PAID $340,542 AS SEVERANCE IN ACCORDANCE WITH THE TERMS OF HER THEN EXISTING EMPLOYMENT AGREEMENT. DURING 2012, THE EMPLOYMENT RELATIONSHIP WITH JOEY ZEPEDA, VICE PRESIDENT - CASE MANAGEMENT ENDED. THE COMPANY NEGOTIATED AND PAID $143,846 AS SEVERANCE IN ACCORDANCE WITH THE TERMS OF HIS THEN EXISTING EMPLOYMENT AGREEMENT. DURING 2012, THE EMPLOYMENT RELATIONSHIP WITH REBECCA M. LEARNER, SENIOR VICE PRESIDENT - COMPLIANCE ENDED. SCAN HEALTH PLAN, A RELATED ENTITY, NEGOTIATED AND PAID $297,571 AS SEVERANCE IN ACCORDANCE WITH THE TERMS OF HER THEN EXISTING EMPLOYMENT AGREEMENT. 4B. THE COMPANY PROVIDES A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN TO ONLY SENIOR EXECUTIVES OF THE COMPANY. SENIOR V.P. AND OFFICERS ARE ELIGIBLE TO PARTICIPATE IN THE SECTION 457(F) PLAN. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE COMPANY'S SECTION 457(F) DURING THE YEAR 2012: RANDY STONE, DOUGLAS JAQUES, REBECCA M. LEARNER AND ELIZABETH RUSSELL. COMPENSATION PURSUANT TO THE TERMS AND CONDITIONS OF THE SECTION 457(F) PLAN, A PARTICIPANT BECOMES 100% VESTED IN THE EMPLOYER CONTRIBUTION UPON THE OCCURRENCE OF ANY OF THE FOLLOWING WHILE THE PARTICIPANT IS AN EMPLOYEE: (I) THE PARTICIPANT HAS TEN YEARS OF CONTINUOUS EMPLOYMENT, COUNTING ONLY SERVICE AFTER DECEMBER 31, 2005; (II) THE PARTICIPANT REACHES THE AGE OF 62 AND HAS FIVE YEARS OF CONTINUOUS EMPLOYMENT; (III) THE PARTICIPANT'S INVOLUNTARY TERMINATION; (IV) THE PARTICIPANT'S DISABILITY; OR (V) THE PARTICIPANT'S DEATH. THERE WAS 1 INDIVIDUAL WHO RECEIVED DISTRIBUTIONS FROM THE SECTION 457(F) PLAN DURING THE YEAR: (1) REBECCA M. LEARNER, $145,843 PART I, LINE 4C: THE FOLLOWING INDIVIDUAL PARTICIPATED IN SCAN HEALTH PLAN'S KEYSOP PLAN DURING THE TAXABLE YEAR: REBECCA LEARNER. THE PLAN HAS BEEN FROZEN SINCE MAY 2002 AND NO EMPLOYEES ARE BEING NEWLY ADDED AS PARTICIPANTS. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS SCAN GROUP, A CALIFORNIA NONPROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER HAS THE POWER TO APPOINT THE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED BY DELOITTE TAX LLP, WORKING IN CONJUNCTION WITH SCAN'S FINANCE DEPARTMENT. SCAN HEALTH PLAN'S ACCOUNTING MANAGER HAS DIRECT RESPONSIBILITY FOR THIS EFFORT, SUBJECT TO SUPERVISION BY THE SCAN HEALTH PLAN ARIZONA'S CHIEF FINANCIAL OFFICER. AFTER AN INITIAL DRAFT OF THE FORM 990 IS PREPARED, IT IS CIRCULATED FOR REVIEW AND COMMENT BY RELEVANT MEMBERS OF THE EXECUTIVE TEAM WHO HAVE RESPONSIBILITY AND/OR KNOWLEDGE ABOUT THE VARIOUS MATTERS DISCLOSED AND/OR DESCRIBED IN THE FORM. THE GENERAL COUNSEL, IN PARTICULAR, REVIEWS THE FORM 990 AND ENSURES ACCURACY OF DESCRIPTIONS AND THAT DISCLOSURE IS COMPLETE. THE DRAFT FORM 990 IS REVIEWED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS OF SCAN GROUP, AND IS SHARED WITH ALL MEMBERS OF THE BOARD OF DIRECTORS AFTER IT IS READY FOR FILING BUT BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C SCAN HEALTH PLAN ARIZONA REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY THROUGH ANNUAL CIRCULATION OF A CONFLICT OF INTEREST QUESTIONNAIRE WHICH IS REQUIRED TO BE ANSWERED BY ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS AND MEMBERS OF EXECUTIVE MANAGEMENT. IN ADDITION, THERE IS REGULAR EDUCATION AND ENFORCEMENT THROUGH OVERSIGHT OF SUCH POLICY AND THE SCAN HEALTH PLAN ARIZONA GIFT AND BUSINESS COURTESIES POLICY WITH RESPECT TO EACH DEPARTMENT BY MEMBERS OF THE SENIOR EXECUTIVE TEAM WITH RESPONSIBILITY FOR SUCH DEPARTMENT. THE LEGAL DEPARTMENT OF SCAN GROUP REVIEWS ALL CONTRACTUAL RELATIONSHIPS ENTERED INTO BY THE ORGANIZATION AND THE GENERAL COUNSEL OF SCAN GROUP IS RESPONSIBLE FOR MONITORING CONFLICTS OF INTEREST THROUGH THE ANNUAL CIRCULATION AND REVIEW OF THE CONFLICT OF INTEREST QUESTIONNAIRE. ACCORDINGLY, THE LEGAL DEPARTMENT OF SCAN GROUP THROUGH THE GENERAL COUNSEL IS IN A POSITION TO MONITOR AND ENFORCE COMPLIANCE WITH THE POLICY ON AN ONGOING BASIS. FORM 990, PART VI, SECTION B, LINE 15 15A: THE PROCESS FOR DETERMINING THE COMPENSATION OF THE PRESIDENT OF SCAN HEALTH PLAN ARIZONA IS CONDUCTED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF SCAN GROUP, ALL OF THE VOTING MEMBERS OF WHICH ARE INDEPENDENT PERSONS. IN DETERMINING THE PRESIDENT'S COMPENSATION, THE COMPENSATION COMMITTEE WORKS WITH AND RELIES UPON THE COUNSEL AND EXPERTISE OF ERNST & YOUNG, A CONSULTANT WITH WELL-ESTABLISHED EXPERIENCE AND EXPERTISE IN THE AREA OF NONPROFIT ORGANIZATION EXECUTIVE COMPENSATION AND COMPLIANCE WITH THE INTERMEDIATE SANCTIONS REQUIREMENTS APPLICABLE TO SUCH COMPENSATION. ERNST & YOUNG PROVIDES AN "EXECUTIVE COMPENSATION REPORT" TO THE COMPENSATION COMMITTEE EACH YEAR WHICH FURNISHES THE BASIS FOR THE ESTABLISHMENT OF THE PRESIDENT'S COMPENSATION PACKAGE DURING THE FOLLOWING YEAR. THE ERNST & YOUNG EXECUTIVE COMPENSATION REPORT IS BASED ON A REVIEW OF THE EXECUTIVE COMPENSATION PRACTICES OF A VARIETY OF ORGANIZATIONS THAT ARE CONSIDERED COMPARABLE TO SCAN HEALTH PLAN ARIZONA BASED ON VARIOUS METRICS. THE COMPENSATION COMMITTEE DELIBERATES ON THE ISSUE OF THE PRESIDENT'S COMPENSATION PACKAGE IN LIGHT OF THE ERNST & YOUNG EXECUTIVE COMPENSATION REPORT AND QUESTIONS ARE ASKED OF, AND ANSWERED BY ERNST & YOUNG, REGARDING SUCH REPORT AND OTHER MATTERS RELEVANT TO SUCH PACKAGE. BASED ON SUCH DELIBERATIONS, THE COMPENSATION COMMITTEE MAKES A RECOMMENDATION TO THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF SCAN HEALTH PLAN REGARDING THE COMPENSATION PACKAGE FOR THE FOLLOWING YEAR. THE MINUTES OF THE COMPENSATION COMMITTEE FOR THESE MEETINGS ARE PREPARED SUBSTANTIALLY CONTEMPORANEOUSLY AND SUBSTANTIATE SUCH DELIBERATIONS AND DECISIONS. 15B: THE PROCESS FOR DETERMINING THE COMPENSATION OF OFFICERS OR OTHER KEY EMPLOYEES OF SCAN HEALTH PLAN ARIZONA IS CONDUCTED BY THE HUMAN RESOURCES DEPARTMENT AND CEO. IN DETERMINING SUCH EMPLOYEE'S COMPENSATION, THE HUMAN RESOURCES DEPARTMENT WORKS WITH AND RELIES UPON THE COUNSEL AND EXPERTISE OF ERNST & YOUNG, A CONSULTANT WITH WELL-ESTABLISHED EXPERIENCE AND EXPERTISE IN THE AREA OF NONPROFIT ORGANIZATION EXECUTIVE COMPENSATION AND COMPLIANCE WITH THE INTERMEDIATE SANCTIONS REQUIREMENTS APPLICABLE TO SUCH COMPENSATION. ERNST & YOUNG PROVIDES AN "EXECUTIVE COMPENSATION REPORT" TO THE HUMAN RESOURCES DEPARTMENT EACH YEAR WHICH FURNISHES THE BASIS FOR THE ESTABLISHMENT OF SUCH EMPLOYEES' COMPENSATION PACKAGE DURING THE FOLLOWING YEAR. THE ERNST & YOUNG EXECUTIVE COMPENSATION REPORT IS BASED ON A REVIEW OF THE EXECUTIVE COMPENSATION PRACTICES OF A VARIETY OF ORGANIZATIONS THAT ARE CONSIDERED COMPARABLE TO SCAN HEALTH PLAN ARIZONA BASED ON VARIOUS METRICS. FORM 990, PART VI, SECTION C, LINE 19 SCAN HEALTH PLAN ARIZONA'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. SCAN HEALTH PLAN ARIZONA'S AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE FROM THE ARIZONA DEPARTMENT OF INSURANCE FOR A NOMINAL FEE. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: FUND TRANSFER FROM SCAN GROUP 28,000,000. SCAN GROUP 3800 KILROY AIRPORT WAY LONG BEACH CA 90806 953826037 ADMIN. SUPPORT CA 501(C)(3) LINE 11, TYPE II N/A 0 SCAN HEALTH PLAN 3800 KILROY AIRPORT WAY LONG BEACH CA 90806 953858259 MEDICARE ADVANTAGE CA 501(C)(3) LINE 9 SCAN GROUP 1 SCAN LONG TERM CARE 3800 KILROY AIRPORT WAY LONG BEACH CA 90806 204607594 MEDICAID MANAGEMENT CARE AZ 501(C)(4) SCAN HEALTH PLAN ARIZONA 1 THE SCAN FOUNDATION 3800 KILROY AIRPORT WAY LONG BEACH CA 90806 450552845 GRANT MAKING CA 501(C)(3) LINE 11, TYPE II SCAN GROUP 1 SCAN 360 CARE 3800 KILROY AIRPORT WAY LONG BEACH CA 90806 352443412 MEDICARE & MEDICAID SERVICES CA 501(C)(3) LINE 9 SCAN GROUP 1 SCAN MANAGEMENT SERVICES COMPANY 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 900860955 MANAGEMENT CA N/A C 0 SCAN WELLNESS CENTER PC 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 900860971 HEALTHCARE CA N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 SCAN HEALTH PLAN P 3709286 SEE PART VII SCAN GROUP P 4466677 SEE PART VII SCAN LONG TERM CARE O 1288093 SEE PART VII SCAN LONG TERM CARE N 116562 SEE PART VII SCAN GROUP S 28000000 CASH SCHEDULE R, PART V: THE PERCENTAGE OF ALLOCATION TO AFFILIATED COMPANIES IS DETERMINED BASED ON ESTIMATED PERCENTAGE OF TIME WORKED, PERCENTAGE OF HEADCOUNTS, AND THE PERCENTAGE OF SCAN MEMBERSHIP, AS APPROPRIATE BASED ON THE NATURE OF THE EXPENSE.