2013-10-21T17:03:07-05:00 2012-12-31 ERNST & YOUNG US LLP 178 S RIO GRANDE STREET SUITE 400 SALT LAKE CITY UT 84101 990 2012-01-01 911729710 COMMUNITY HEALTH PLAN OF WASHINGTON % STACY KESSEL COMM 2066527174 720 OLIVE WAY Suite 300 SEATTLE WA 98101 Lance Hunsinger 2013-10-14 8013503300 2012 2016-02-24 21:20:13Z LANCE HUNSINGER 720 OLIVE WAY SEATTLE WA 98101 983573140 false X WWW.CHPW.ORG X 1996 WA DELIVER MANAGED CARE SERVICES. 19 19 393 1 0 0 0 706397907 876212768 3853398 10665597 1572688 0 711823993 886878365 0 0 0 0 36736155 37450427 0 0 0 663671910 840603580 700408065 878054007 11415928 8824358 210711434 313999249 105662170 187907631 105049264 126091618 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 799818652 0 876212768 THE COMMUNITY HEALTH PLAN OF WASHINGTON (THE PLAN) PROVIDES HEALTHCARE SERVICES COVERAGE TO THE ENROLLEES OF THE STATE OF WASHINGTON DEPARTMENT OF SOCIAL AND HEALTH SERVICES HEALTH CARE AUTHORITY (HCA), HEALTHY OPTIONS (HO), CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP), MANAGED MEDICAID PROGRAMS AND MEDICAL CARE SERVICES (MCS). THE PLAN ALSO PROVIDES HEALTH COVERAGE TO ENROLLEES OF BASIC HEALTH PLAN (BHP) AND MEDICARE ADVANTAGE. COVERAGE IS PROVIDED THROUGH A NETWORK OF CONTRACTED PROVIDERS. 799818652 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 3270 0 true 393 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 Peggy Hopkins 1.0 1.0 X X 0 0 0 Thomas Trompeter 1.0 1.0 X X 0 0 0 Sheila Chilson 1.0 1.0 X X 0 0 0 Barbara Malich 1.0 1.0 X X 0 0 0 Linda McVeigh 1.0 1.0 X 0 0 0 Carla DewBerry 1.0 1.0 X 0 0 0 Cristobal Guillen 1.0 1.0 X 16000 0 0 Diana Bader 1.0 1.0 X 12300 0 0 David Flentge 1.0 1.0 X 0 0 0 Bob Farrell 1.0 1.0 X 0 0 0 Dian Cooper 1.0 1.0 X 0 0 0 Michael Hassing 1.0 1.0 X 0 0 0 Desmond Skubi 1.0 1.0 X 0 0 0 Teresita Batayola 1.0 1.0 X 0 0 0 Mark Secord 1.0 1.0 X 0 0 0 Desiree Sweeney 1.0 1.0 X 0 0 0 Tom Hochwalt 1.0 1.0 X 0 0 0 Juan Cordova 1.0 1.0 X 0 0 0 Steven Clark 1.0 1.0 X 0 0 0 Anita Monoian 1.0 1.0 X 0 0 0 Carlos Olivares 1.0 1.0 X 0 0 0 Malcolm Butler 1.0 1.0 X 0 0 0 Lance Hunsinger 29.0 11.0 X 522427 0 28174 Wade J Harman 29.0 11.0 X 283846 0 18382 Stacy Kessel 29.0 11.0 X 343110 0 18714 Marilee K McGuire 29.0 11.0 X 366733 0 24637 Alan Lederman 29.0 11.0 X 339112 0 18080 Victor Collymore 29.0 11.0 X 45288 0 203 Howard Springer 29.0 11.0 X 331064 0 13875 Pam Sullivan 29.0 11.0 X 146182 0 18331 Gordon Yenokida 29.0 11.0 X 105249 0 0 Stephen Swanson 29.0 11.0 X 200419 0 14847 Mike Evans 29.0 11.0 X 223619 0 17240 Abie Castillo 29.0 11.0 X 220673 0 20528 Rachel Koh 29.0 11.0 X 194364 0 17240 Lucy Sutphen 29.0 11.0 X 287442 0 29214 3637828 0 239465 54 false true false CENSOHEALTH LLC 4055 VALLEY VIEW LANE STE 400 DALLAS TX 75244 HEALTHCARE CONSULT. 1280125 AIM HEALTHCARE SERVICES INC 1021 WINDCROSS COURT NASHVILLE TN 37067 HEALTHCARE CONSULT. 693831 POPHEALTHMAN 2526 N 56TH STREET PHOENIX AZ 85008 HEALTHCARE CONSULT. 645350 KFORCER PROFESSIONAL STAFFING PO BOX 277997 ATLANTA GA 30384 CS TEMPORARY 538922 AEROTEK INC 7301 PARKWAY DRIVE HANOVER MD 21076 CS TEMPORARY 497084 26 0 PREMIUM EARNED 900099 876212768 876212768 876212768 3519320 3519320 0 0 0 0 0 103841052 96694775 7146277 7146277 7146277 0 0 0 0 886878365 876212768 10665597 0 0 0 0 2462090 2462090 0 32218337 5112147 27106190 967870 151363 816507 0 1802130 320989 1481141 0 692520 692520 4386211 4386211 0 0 0 22017205 14571435 7445770 1599115 1599115 2575790 357723 2218067 423935 423935 0 3049510 3049510 551028 18506 532522 0 0 0 0 5629934 306669 5323265 351396 18698 332698 MEDICAL AND HOSPITAL EXPENSES 777159834 777159834 TAXES, LICENSES, AND FEES 19936683 19936683 BOARDS, BUREAUS, AND ASSOC. 228278 6341 221937 COLLECTION & BANK SVC CHARGE 207194 207194 1794947 1794947 878054007 799818652 78235355 0 65203058 117624627 0 0 0 0 7982496 19408741 0 0 0 0 0 0 0 0 0 0 1266148 488667 641658 777481 134076388 172753035 0 0 0 0 0 0 2807834 3435365 210711434 313999249 105662170 187907631 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105662170 187907631 X 0 0 33559486 14738448 71489778 111353170 105049264 126091618 210711434 313999249 X 8824358 -2382647 14600643 X false true X true false 1266148 488667 777481 777481 0 0 X 886878365 886878365 886878365 878054007 878054007 878054007 FIN 48 (ASC 740) FOOTNOTE SCHEDULE D, PART X, LINE 2 AS OF DECEMBER 31, 2012 AND 2011, THE NETWORK HAS NO UNCERTAIN TAX POSITIONS, AND IN ACCORDANCE WITH ACCOUNTING GUIDANCE, HAS NOT RECORDED A CONTINGENT LIABILITY. THERE ARE NO TAX POSITIONS FOR WHICH MANAGEMENT BELIEVES IT IS REASONABLY POSSIBLE THAT THE TOTAL AMOUNT OF TAX CONTINGENCIES WILL SIGNIFICANTLY INCREASE OR DECREASE WITHIN 12 MONTHS OF THE REPORTING DATE. X X X true false false false false false false false false Lance Hunsinger 377427 0 128000 0 17000 0 22500 0 5674 0 550601 0 0 0 Wade J Harman 213190 0 70656 0 0 0 15142 0 3240 0 302228 0 0 0 Stacy Kessel 256860 0 86250 0 0 0 17000 0 1714 0 361824 0 0 0 Marilee K McGuire 276620 0 90113 0 0 0 21797 0 2840 0 391370 0 0 0 Alan Lederman 254304 0 84808 0 0 0 17000 0 1080 0 357192 0 0 0 Howard Springer 112118 0 74137 0 144809 0 9761 0 4114 0 344939 0 0 0 Pam Sullivan 146182 0 0 0 0 0 14617 0 3714 0 164513 0 0 0 Stephen Swanson 169092 0 31327 0 0 0 12173 0 2674 0 215266 0 0 0 Mike Evans 186382 0 37237 0 0 0 17000 0 240 0 240859 0 0 0 Abie Castillo 182874 0 37799 0 0 0 16270 0 4258 0 241201 0 0 0 Rachel Koh 162655 0 31709 0 0 0 17000 0 240 0 211604 0 0 0 Lucy Sutphen 232100 0 38342 0 17000 0 22500 0 6714 0 316656 0 0 0 SEVERANCE PAYMENTS SCHEDULE J, PART I, LINE 4A THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT IN 2012: HOWARD SPRINGER - $137,809 DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PART VI, LINE 6 THE ORGANIZATION HAS 1 CORPORATE MEMBER, COMMUNITY HEALTH NETWORK OF WASHINGTON ("CHNW"), A RELATED 501(C)(4) TAX EXEMPT ENTITY. DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS FORM 990, PART VI, LINE 7A 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 MEMBER. DURING 2012, ALL CHPW BOARD MEMBERS SERVED ON THE CHNW BOARD. DESCRIPTION OF CLASSES OF PERSON AND DECISIONS REQUIRING APPROVAL FORM 990, PART VI, LINE 7B 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. DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, LINE 11B THE 990 IS REVIEWED BY THE DIRECTOR OF FINANCIAL REPORTING, CHIEF FINANCIAL OFFICER, CHIEF LEGAL OFFICER, AND CHIEF EXECUTIVE OFFICER. THE CHIEF FINANCIAL OFFICER THEN PRESENTS IT TO THE FINANCE COMMITTEE AND THE BOARD OF DIRECTORS FOR REVIEW BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, LINE 12C 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. OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN FORM 990, PART VI, LINE 15A AND 15B 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 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 BOARD MINUTES. THIS PROCESS WAS LAST COMPLETED IN 2012. AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, LINE 19 COPIES OF GOVERNANCE DOCUMENTS, CONFLICT 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. BOARD COMPENSATION FORM 990, PART VII 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. - PEGGY HOPKINS - THOMAS TROMPETER - SHEILA CHILSON - BARBARA MALICH - LINDA MCVEIGH - DAVID FLENTGE - BOB FERRELL - DIAN COOPER - MICHAEL HASSING - DESMOND SKUBI - TERESITA BATAYOLA - MARK SECORD - DESIREE SWEENEY - TOM HOCHWALT - JUAN CORDOVA - STEVEN CLARK - ANITA MONOIAN - CARLOS OLIVARES OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 9 CHANGE IN NONADMITTED ASSETS $ 2,200,642 ISSUANCE OF SURPLUS NOTE $12,400,000 ROUNDING $ 1 ------------ TOTAL $14,600,643 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 true true true