CHP OF WASHINGTON: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
CHP OF WASHINGTON (EIN 91-1729710)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-10-09
IRS object ID
201212839349300691
Schema version
2011v1.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-10-09T17:41:13-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1178 S RIO GRANDE STREET SUITE 400AddressLine1
CitySALT LAKE CITYCity
StateUTState
ZIP Code84101ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN911729710EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HEALTH PLAN OF WASHINGTONBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% LANCE HUNSINGERInCareOfName
Name ControlCOMMNameControl
Phone2066138997Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1720 OLIVE WAYAddressLine1
CitySEATTLECity
StateWAState
ZIP Code98101ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSTACY A KESSEELName
TitleCFOTitle
Date Signed2012-10-05DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone8013503300Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSTACY KESSELNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1720 OLIVE WAYAddressLine1
CitySEATTLECity
StateWAState
ZIP Code98101ZIPCode
FieldValueIRS element (for citing)
Gross Receipts732085923GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.CHPW.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1996YearFormation
State Legal DomicileWAStateLegalDomicile
Activity Or Mission DescriptionDELIVER MANAGED CARE SERVICESActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees361TotalNbrEmployees
Total Nbr Volunteers1TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year610158112ProgramServiceRevenuePriorYear
Program Service Revenue CY706397907ProgramServiceRevenueCY
Investment Income Prior Year5358555InvestmentIncomePriorYear
Investment Income Current Year3853398InvestmentIncomeCurrentYear
Other Revenue Prior Year15720OtherRevenuePriorYear
Other Revenue Current Year1572688OtherRevenueCurrentYear
Total Revenue Prior Year615532387TotalRevenuePriorYear
Total Revenue Current Year711823993TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year30966434SalariesEtcPriorYear
Salaries Etc Current Year36736155SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year563180484OtherExpensePriorYear
Other Expenses Current Year663671910OtherExpensesCurrentYear
Total Expenses Prior Year594146918TotalExpensesPriorYear
Total Expenses Current Year700408065TotalExpensesCurrentYear
Revenues Less Expenses Prior Year21385469RevenuesLessExpensesPriorYear
Revenues Less Expenses CY11415928RevenuesLessExpensesCY
Total Assets BOY183279638TotalAssetsBOY
Total Assets EOY210711434TotalAssetsEOY
Total Liabilities BOY90690621TotalLiabilitiesBOY
Total Liabilities EOY105662170TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY92589017NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY105049264NetAssetsOrFundBalancesEOY
Mission DescriptionTO 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.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense630102496Expense
Grants0Grants
Revenue707970595Revenue
DescriptionTHE 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 MEDICAL ASSISTANCE ADMINISTRATION'S (MAA), HEALTHY OPTIONS (HO), CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP), MANAGED MEDICAID PROGRAMS AND THE DISABILITY LIFELINE PROGRAM (DL). THE PLAN ALSO PROVIDES HEALTH COVERAGE TO ENROLLEES OF THE STATE OF WASHINGTON HEALTHCARE AUTHORITY (HCA) BASIC HEALTH PLAN (BHP) AND MEDICARE ADVANTAGE. COVERAGE IS PROVIDED THROUGH A NETWORK OF CONTRACTED PROVIDERS.Description
Total Program Service Expense630102496TotalProgramServiceExpense
Described In501 C3falseDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10962934NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees361NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonLANCE HUNSINGERNamePerson
Telephone Number2065218833TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1720 OLIVE WAY SUITE 300AddressLine1
CitySEATTLECity
StateWAState
ZIP Code98101ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Linda McVeigh
Chair of the Board1.0XX000
Diana Bader
Vice Chair of the Board1.0XX1560000
Thomas Trompeter
Director, Treasurer1.0XX000
Peggy Hopkins
Director, Secretary1.0XX000
Sheila Chilson
Director1.0X000
Mark Secord
Director1.0X000
Juan Olivares
Director1.0X000
Dian Cooper
Director1.0X000
Malcom Butler
Director1.0X000
Carla DewBerry
Director1.0X000
Cristobal Guillen
Director1.0X2640000
Lance Hunsinger
Chief Executive Officer32.0X527326063280
Stacy Kessel
Chief Financial Officer32.0X278848036914
Wade Harman
Chief Legal Officer32.0275268042346X
Marilee Mcguire
Chief Operating Officer32.0347208047274X
Christopher Mathews
Chief Medical Officer32.0240679023300X
Alan Lederman
SVP, BUS. INTELLIGENCE/TPA OPS32.0338609048361X
Howard Springer
SVP, Business Development32.0305512052121X
Laura Boyd
VP, HR & ORG Effectiveness32.0193239015258X
Jogaratnam Vernidharan MD
Medical Director32.0261619040600X
Abie Castillo
VP, Network Development32.0227563045299X
Michael Evans
VP, Customer Care Ops32.0219478032712X
Lucy Sutphen
Medical Director32.0218626024948X
Rachel Tong-Siew Koh
AVP, Pharmacy32.0184560027882X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3660535TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation500295TotalOtherCompensation
Number Individuals GT100 K59NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Zeomega Inc
3010 Gaylord Parkway Suite 210FRISCOTX75034SOFTWARE CONSULTING865899
Oleen HealthCare Information
8484 Georgia Avenue Suite 600SILVER SPRINGMD20910HEALTHCARE CONSULT.785550
Aerotek Inc
7301 Parkway DrHANOVERMD21076CS TEMPORARY764346
CensoHealth LLC
4055 Valley View Lane Suite 400DALLASTX75244HEALTHCARE CONSULT.665625
IRP Global LLC
10408 Marchant LnIRVINGTX75063IT CONSULTING638534
FieldValueIRS element (for citing)
Number Of Contractors GT100 K28NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPREMIUM EARNEDDescription
Business Code900099BusinessCode
Total Revenue Column706397907TotalRevenueColumn
Related Or Exempt Function Income706397907RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue706397907TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2906649TotalRevenueColumn
Exclusion$2,906,649ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities21208679Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities20261930Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities946749Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column946749TotalRevenueColumn
Exclusion$946,749ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMCS HOSPITAL SAVING REVENUEDescription
Business Code900099BusinessCode
Total Revenue Column1572688TotalRevenueColumn
Related Or Exempt Function Income1572688RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue1572688TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column711823993TotalRevenueColumn
Related Or Exempt Function Income707970595RelatedOrExemptFunctionIncome
Exclusion$3,853,398ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2953317Total
Management And General2953317ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total31602285Total
Program Services3471125ProgramServices
Management And General28131160ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total586950Total
Program Services24035ProgramServices
Management And General562915ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1593603Total
Program Services218980ProgramServices
Management And General1374623ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total469564Total
Management And General469564ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total4531048Total
Program Services472969ProgramServices
Management And General4058079ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total1184253Total
Management And General1184253ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total3252340Total
Program Services161135ProgramServices
Management And General3091205ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total311095Total
Management And General311095ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2871775Total
Management And General2871775ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total411273Total
Program Services14714ProgramServices
Management And General396559ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total5038238Total
Program Services192945ProgramServices
Management And General4845293ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total283193Total
Program Services4300ProgramServices
Management And General278893ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL AND HOSPITAL EXPENSES613366536613366536
TAXES, LICENSES, AND FEES1615927416159274
OUTSOURCED SERVICES15471764120377993433965
BOARDS, BUREAUS, AND ASSOC.1904136814183599

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total131144Total
Program Services131144ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total700408065Total
Program Services630102496ProgramServices
Management And General70305569ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY69290877BOY
EOY65203058EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY9887241BOY
EOY7982496EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis3857455LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec3215797LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY272583BOY
EOY641658EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY101152499BOY
EOY134076388EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2676438BOY
EOY2807834EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY183279638BOY
EOY210711434EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY90690621BOY
EOY105662170EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY90690621BOY
EOY105662170EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY33559486BOY
EOY33559486EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY59029531BOY
EOY71489778EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY92589017BOY
EOY105049264EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY183279638BOY
EOY210711434EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses11415928ReconcilationRevenueExpenses
Reconcilation Other Changes1044319ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3857455OtherCostOrOtherBasis
Depreciation3215797Depreciation
Book Value641658BookValue
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildings
Total Of Book Value Land Buildings641658TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability
Total Of Amounts0TotalOfAmounts
Total Revenue711823993TotalRevenue
Total Expenses700408065TotalExpenses
Excess Or Deficit For Year11415928ExcessOrDeficitForYear
Net Unrealized GL On Investments-260055NetUnrealizedGLOnInvestments
Other$1,304,374OtherAmount
Total Adjustments1044319TotalAdjustments
Excess Or Deficit Per FS12460247ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt711692849TotRevenueEtcAuditedFinclStmt
Other Revenues-131144OtherRevenues
Revenue Not Rptd F990-131144RevenueNotRptdF990
Revenue Subtotal711823993RevenueSubtotal
Total Revenue Per Form990711823993TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt700276921TotExpensesEtcAuditedFinclStmt
Expenses Subtotal700276921ExpensesSubtotal
Other Expenses Not Included131144OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt131144ExpensesNotRptdOnFinStmt
Total Expenses Per Form990700408065TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
FIN 48 (ASC 740) FOOTNOTESCHEDULE D, PART X, LINE 2AS OF DECEMBER 31, 2011 AND 2010, 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.
OTHER CHANGE IN RECONCILIATION OF CHANGE IN NET ASSETSSCHEDULE D, PART XI, LINE 8CHANGE IN NONADMITTED ASSETS $1,304,374
OTHER CHANGE IN RECONCILIATION OF REVENUE PER AFSSCHEDULE D, PART XII, LINE 2DRECLASS P2P EXPENSES ($131,144)
OTHER CHANGE IN RECONCILIATION OF EXPENSE PER AFSSCHEDULE D, PART XIII, LINE 4BRECLASS OF P2P EXPENSES $131,144

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Lance Hunsinger
37882601320000165000412310220490590606000
Wade Harman
20026807500000033000093460317614000
Stacy Kessel
206955071893000227870141270315762000
Marilee Mcguire
259289087919000316980155760394482000
Christopher Mathews
136528010415100018088052120263979000
Alan Lederman
247184091425000299060184550386970000
Howard Springer
218667082500043450290720230490357633000
Laura Boyd
38707063722090810012500027580208497000
Jogaratnam Vernidharan MD
210869050750000253740152260302219000
Abie Castillo
1724530386100165000236660216330272862000
Michael Evans
17988903958900026366063460252190000
Lucy Sutphen
161526040600016500073700175780243574000
Rachel Tong-Siew Koh
15109803346200019460084220212442000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSEVERANCE PAYMENTSIdentifier
Return ReferenceSCHEDULE J, PART I, LINE 4AReturnReference
ExplanationTHE FOLLOWING INDIVIUDAL RECEIVED A SEVERANCE PAYMENT IN 2011: LAURA BOYD - $90,810Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERSFORM 990, PART VI, LINE 6THE 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 RIGHTSFORM 990, PART VI, LINE 7ATHE 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 2011, CHNW AND THE ORGANIZATION HAD IDENTICAL BOARDS OF DIRECTORS.
DESCRIPTION OF CLASSES OF PERSON AND DECISIONS REQUIRING APPROVALFORM 990, PART VI, LINE 7BTHE 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 990FORM 990, PART VI, LINE 11BTHE 990 IS REVIEWED BY THE ASSISTANT CONTROLLER, CONTROLLER, 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 INTERESTFORM 990, PART VI, LINE 12CALL 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 CONFLICTS 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 BEGUNFORM 990, PART VI, LINE 15A AND 15BAT 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 2011.
AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLICFORM 990, PART VI, LINE 19COPIES 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 PLAN FINANCIAL STATEMENTS ARE POSTED ON THE OIC WEBSITE.
HOURS DEVOTED TO RELATED ORGANIZATIONSFORM 990, PART VIITHE OFFICERS, KEY EMPLOYEES, AND FIVE HIGHEST PAID EMPLOYEES REPORTED IN PART VII DEVOTE 8 HOURS PER WEEK TO CHNW.
BOARD COMPENSATIONFORM 990, PART VIITHE 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. - LINDA MCVEIGH - THOMAS TROMPETER - PEGGY HOPKINS - SHEILA CHILSON - MARK SECORD - JUAN OLIVARES - DIAN COOPER - MALCOM BUTLER
OTHER CHANGES IN NET ASSETSFORM 990, PART XI, LINE 5CHANGE IN NONADMITTED ASSETS $1,304,374 UNREALIZED LOSS ON INVESTMENTS ($ 260,055) ------------ TOTAL $1,044,319

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Community Health Network of WashingtonBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1720 Olive Way Suite 300AddressLine1
CitySeattleCity
StateWAState
ZIP Code98101ZIPCode
FieldValueIRS element (for citing)
EIN911577184EIN
Primary ActivitiesHealthCarePrimaryActivities
Legal Domicile StateWALegalDomicileState
Exempt Code Section501(C)(4)ExemptCodeSection

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Controlled OrgfalseControlledOrg

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1NW-A HOLDINGS INC DBA ADAPTISBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1720 OLIVE WAY SUITE 300AddressLine1
CitySEATTLECity
StateWAState
ZIP Code98101ZIPCode
FieldValueIRS element (for citing)
EIN911739404EIN
Primary ActivityADMIN. SERVICESPrimaryActivity
Legal Domicile StateWALegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1CHNWBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityC-CORPTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.