2012-11-13T11:33:46-06:00 2011-12-31 PRICEWATERHOUSCOOPERS LLP 2001 MARKET ST SUITE 1700 PHILADELPHIA PA 19103 990 2011-01-01 930798039 KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST % VP - NATIONAL TAX COMPLIANCE KAIS 5102716611 ONE KAISER PLAZA 15L OAKLAND CA 94612 DEBORAH STOKES 5102716385 2012-11-02 2673303000 2011 2016-02-24 21:20:13Z ANDREW R MCCULLOCH ONE KAISER PLAZA 15L OAKLAND CA 94612 3202133905 false X N/A X 1984 OR To provide high-quality, affordable health care services to improve the health of our members and the communities we serve. 14 12 7000 102 6615880 56498 34240 2682950846 2817773409 29927694 21487196 13216018 24729746 2726151056 2864024591 338109 274273 0 0 661685670 726642417 0 0 0 2042758098 2123400985 2704781877 2850317675 21369179 13706916 1024197650 1228271737 941102794 1266392539 83094856 -38120802 X TO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE. false false 2670637561 0 2796342897 MEMBER HEALTH CARE SERVICES AND MEDICAL TRAINING FOR CARE IMPROVEMENT KAISER FOUNDATION HEALTH PLAN OF NORTHWEST (KFHP OF NORTHWEST) PROVIDES HOSPITAL, MEDICAL, AND SURGICAL CARE, INCLUDING URGENT CARE SERVICES, EXTENDED CARE AND HOME HEALTH CARE, FOR ITS MEMBERS WITHOUT REGARDS TO AGE, SEX, RACE, RELIGION OR NATIONAL ORIGIN OR THE ABILITY TO PAY. KFHP OF NORTHWEST EDUCATES AND TRAINS MEDICAL STUDENTS AND OTHER HEALTH CARE PROFESSIONALS AND PROMOTES SCIENTIFIC AND NURSING EDUCATION IN ORDER TO IMPROVE CARE. ADDITIONAL INFORMATION ABOUT NORTHWEST HEALTH PLAN'S CHARITABLE ACTIVITIES CAN BE FOUND IN SCHEDULE O. 28071122 0 14671517 Participation in Medicaid and Other Government Sponsored Programs Northwest Health Plan is committed to improving the way Medicaid beneficiaries receive care, not only in our facilities, but also in the communities we serve. In 2011, Northwest Health Plan participated in a number of government programs. Medicaid Managed Care - providing comprehensive care for more than 7,603 managed care members and the Medicaid FFS program. ADDITIONAL INFORMATION ABOUT NORTHWEST HEALTH PLAN'S CHARITABLE ACTIVITIES CAN BE FOUND IN SCHEDULE O. 15596865 0 150741 Charitable Care (Medical Financial Assistance and Charitable Coverage) Health Plan provides charity care to low-income vulnerable patients through the Medical Financial Assistance (MFA) and Charitable Health Coverage (CHC) Programs. MFA - Health Plan offers financial assistance to help families and individuals that are unable to pay for all or part of the cost of urgent or emergent care provided in Kaiser Permanente facility. CHC - these programs are available to low income adults and children who are not eligible for other public or privately sponsored coverage. More than 4,583 patients received comprehensive care for up to four years through these programs. ADDITIONAL INFORMATION ABOUT NORTHWEST HEALTH PLAN'S CHARITABLE ACTIVITIES CAN BE FOUND IN SCHEDULE O. 1947358 274273 0 SEE SCHEDULE O COMMUNITY BENEFIT REPORT 1947358 274273 0 2716252906 true false false true false false false false false true false false false true false true true false false false false false false false false false true false true false false false false false false false false false false false false true true true true false false true 4290 0 true 7000 true true true false false false false false false false false false X 14 12 false false true false true true true true true false false true true true true true true true true false OR WA X VP - NATIONAL TAX COMPLIANCE 5102716385 ONE KAISER PLAZA 15L OAKLAND CA 94612 X Christine Cassel 0.5 X 0 184500 0 Thomas Chapman 1.0 X 0 191695 89109 Daniel Garcia 2.0 X 0 1228765 73604 William Graber 0.5 X 0 208269 0 J Eugene Grigsby III 1.0 X 0 210900 0 George Halvorson 5.0 X X 0 7861915 74595 Judith Johansen 0.5 X 0 200075 0 Kim J Kaiser 0.5 X 0 124500 0 Philip Marineau 0.5 X 0 200769 0 Jenny Ming 0.3 X 0 179269 0 Edward Pei 0.5 X 0 173000 16500 Margaret Porfido 0.5 X 0 35013 0 J Neal Purcell 0.5 X 0 234858 0 Cynthia Telles 0.5 X 0 204613 0 Sandra Thompkins 0.5 X 0 39031 0 Kathryn Lancaster 4.0 X 0 2109102 289626 Donna Lynne 4.0 X 0 1314917 222947 Andrew McCulloch 25.0 X 0 818911 219483 Thomas Meier 3.0 X 0 802247 110802 Donald Orndoff 5.0 X 0 634274 137999 Arthur Southam 5.0 X 0 2649224 348687 Deborah Stokes 4.0 X 0 720302 118018 Bernard Tyson 5.0 X 0 2800296 482152 William Wiechmann 50.0 X 0 432535 78860 Victoria Zatkin 4.0 X 0 314768 84531 Mark Zemelman 3.0 X 0 778576 191923 Mark Charpentier 30.0 X 0 413400 85710 Mark Enger 30.0 X 0 631009 107523 Susan Hennessy 30.0 X 0 805850 293708 Susan Mullaney 30.0 X 0 300298 41231 Karen Schartman 30.0 X 0 484692 86025 Stephen Shawn Barton 30.0 X 0 283224 30064 Mary Durham 30.0 X 0 332723 106604 Eleanor Godfrey 30.0 X 0 280280 88227 Michael Kinard 30.0 X 0 319054 74903 Richie Smith 30.0 X 0 354540 70580 Steven Zatkin 0.0 X 0 574121 76925 0 29431515 3600336 761 true true false NORTHWEST PERMANENTE PC 500 NE MULTNOMAH STREET PORTLAND OR 97232 MEDICAL SERVICES 441565100 PERMANENTE DENTAL ASSOCIATES 500 NE MULTNOMAH STREET PORTLAND OR 97232 DENTAL SERVICES 39239107 PEACEHEALTH 1615 DELAWARE ST LONGVIEW WA 98632 HOSPITAL SERVICES 20629206 OREGON HEALTH SCIENCE UNIVERSITY 3181 SW SAM JACKSON PARK RD PORTLAND OR 97201 HOSPITAL SERVICES 22473400 KAISER FOUNDATION HOSPITALS 500 NE MULTNOMAH STREET PORTLAND OR 97232 HOSPITAL SERVICES 641834284 286 34240 34240 MBR HLTH CARE PREM 621400 2022414518 2022414518 SUPPL CHARGE/PHARM 621400 136450099 129841845 6608254 NON-PLAN & IND REV 621400 9194093 9194093 OTHER PRGRM SERV 621400 19188175 19188175 MEDICARE 621400 630526524 630526524 2817773409 18183561 18183561 0 0 1001936 551732 450204 450204 7626 442578 340732068 129149 337222797 334785 3509271 -205636 3303635 3303635 0 0 0 MISC REVENUE 900099 24279542 24279542 24279542 2864024591 2811165155 6615880 46209316 274273 274273 0 0 0 0 0 436426262 405774686 30651576 0 69211288 69211288 185335023 166059275 19275748 35669844 35653423 16421 0 1116760 1116760 1613437 1613437 298078 298078 0 450352 450352 346068251 320843493 25224758 3882013 337756 3544257 7872798 7024772 848026 139434939 117507917 21927022 0 13204281 13202729 1552 2656153 2307966 348187 0 850651 850651 2401994 2401994 0 34176808 34176808 14332964 14332796 168 BASIC CONTRACT PAYMENTS 1110320960 1110320960 SUPPLIES 328846477 306585316 22261161 INTER-REGIONAL CHARGES 65612688 61506981 4105707 STATE & LOCAL TAXES 23183455 23183455 27077926 25547018 1530908 2850317675 2716252906 134064769 0 5377638 6752684 0 0 0 0 55396885 66729582 0 0 0 0 0 0 23191438 23583251 4963066 4638486 588895530 331506718 246284447 257388812 686306705 820134401 0 0 0 0 0 0 2677471 49044521 1024197650 1228271737 142589262 181729185 0 0 26266333 24948898 0 0 0 0 0 0 0 0 0 0 772247199 1059714456 941102794 1266392539 X 4712722 4712722 0 0 78382134 -42833524 83094856 -38120802 1024197650 1228271737 X 13706916 -134922574 X false true true X false X 56498 34240 90738 2346496968 2461397785 2573087902 2682950846 2817773409 12881706910 2346496968 2461397785 2573087902 2683007344 2817807649 12881797648 12881797648 31794233 30524341 26785941 22587692 19185497 130877704 31794233 30524341 26785941 22587692 19185497 130877704 2378291201 2491922126 2599873843 2705595036 2836993146 13012675352 0.98994 0.98846 0.01006 0.01154 X false false true false false false false true 184721 true 40408 true 72949 298078 false Schedule C, Part II-B, Lines 1a through 1i LOBBYING ACTIVITY BY NONELECTING PUBLIC CHARITIES The Organization is a member of the Kaiser Permanente Medical Care Program and participated and benefited from lobbying activities conducted at the regional and national level for the benefit of its enrolled members and for the health care industry as a whole. As an organization generally exempt from income tax under Internal Revenue Code Section 501(c)(3), Health Plan has a policy prohibiting internal involvement in any political campaigns. This policy is closely monitored for compliance. During the year this Organization may have made comments or statements concerning legislation which may affect the health care industry. Health Plan may have engaged in telephone conversations and/or written letters to various federal, state, and local officials regarding matters which affected the healthcare industry as a whole. The amount of time and money involved in the activities is detailed on lines a through i. Health Plan has several employees and/or may retain a professional consultant to represent Health Plan's interests in various legislative and regulatory bodies and from time-to-time to keep informed of Federal and State legislation having an impact on Health Plan's charitable activities as an exempt Health Maintenance Organization. These individuals attempt to ensure that proposed legislation and enacted laws are compatible with the Interest of Health Plan and its members by performing the following activities: (i) Collecting, analyzing and distributing within the Organization, public and private policy recommendations regarding proposed legislation that affect the operation of Health Plan and its ability to provide quality health and medical care services to its members in a cost effective environment. (ii) Providing appropriate informational materials to legislators and to their staffs that pertain to matters of common interest in the health care community and in the not-for-profit community. (iii) Also by preparing written and oral testimony, these individuals appear at legislative hearings, monitor legislative proceedings and meet with legislators and/or their staffs regarding issues pertinent to the mission of Health Plan. Those individuals appearing at such hearings and meetings for and on behalf of Health Plan often are representing the interests of common interest groups as well as the interests of the members of Health Plan. (iv) Other employees and officers perform services by delivering speeches at various public and private functions and in serving as faculty in healthcare related educational programs throughout the community. 31777408 31777408 380880969 226201341 154679628 21853088 10290595 11562493 136630922 85496900 51134022 17753143 9517882 8235261 257388812 0 SELF-INSURED RISK - PPL 63394920 SELF-INSURED RISK - AUTO & UNEMPLOYMENT 385000 SELF-INSURED RISK - WORKERS COMP 5174515 POST RETIREMENT BENEFIT-LT 953994770 POST RETIREMENT BENEFIT-CURRT 9506014 OTHER LIABILITIES 27259237 1059714456 2864024591 2850317675 13706916 -2800671 -132121903 -134922574 -121215658 2854462266 -2800671 1773342 -1027329 2855489595 8534996 8534996 2864024591 2975677926 133678499 133678499 2841999427 8318248 8318248 2850317675 Schedule D, Part XI, Line 8 Change in Other Comprehensive Income $ (131,015,961) Gain/loss on sale of investments - tax (3,509,271) Gain/loss on sale of investments - book 4,954,272 See "note 1" (2,550,943) TOTAL $ (132,121,903) note 1: other than temporary impairment ("OTTI") of investment recognized for financial statement purposes, which will be tax-reported when realized Schedule D, Part XII, Line 2d Gain/loss on sale of investments - book $ 4,954,272 OTTI Losses (2,550,943) Interentity revenue reclass 7,688,261 Net Internal Interest reclass (2,060,062) Investment management fee reclass (450,352) Bad Debt expense reclass (5,807,834) total $ 1,773,342 Schedule D, Part XII, Line 4b Gain/loss on sale of investments - tax 3,509,271 Rental expenses reclass (551,732) Gain/loss on sale of fixed assets reclass (209,330) Miscellaneous revenue reclass 5,786,787 Total $ 8,534,996 Schedule D, Part XIII, Line 2d CHANGE IN OTHER COMPREHENSIVE INCOME $ 131,015,963 Interentity Expense reclass 7,688,261 Misc Expenses reclass (5,786,787) RENTAL EXPENSES RECLASS 551,732 GAIN/LOSS ON SALE OF FIXED ASSETS RECLASS 209,330 Total $ 133,678,499 Schedule D, Part XIII, Line 4b Bad Debt expense reclass $ 5,807,834 INVESTMENT MANAGEMENT FEE RECLASS 450,352 Net Internal Interest reclass 2,060,062 Total $ 8,318,248 Schedule D, Part X, QUESTION 2 NOT REQUIRED true Albertina Kerr Centers 424 NE 22nd Avenue Portland OR 97232 930386780 501(c)(3) 7100 Spotlight at Kerr 2011 Event Support\Annual Fundra American Heart Assoc - Pacific Mtn Affiliate 1200 NW Naito Pkwy 220 Portland OR 97209 135613797 501(c)(3) 25000 Start! Greater Portland Heart & Stroke Walk 2011 E City of Hillsboro 150 E Main Street Hillsboro OR 97123 936002183 Government 7825 Celebrate Hillsboro 2011 Other Dental Foundation of Oregon PO Box 3710 Wilsonville OR 97070 930818476 501(c)(3) 10000 Oregon Mission of Mercy (MOM II) Event Support\Hea Morrison Center 9911 SE Mt Scott Blvd Portland OR 97266 930354176 501(c)(3) 5600 Cooking for Kids Series 2011 Event Support\Dinner Portland Schools Foundation 2069 NE Hoyt Portland OR 97232 931149789 501(c)(3) 9600 Roast Festival 2011 Event Support\Annual Fundraise CareOregon Community Health LLC 315 SW 5th Ave 900 Portland OR 97204 272429270 501(c)(3) 50000 Oral Health Initiat Upstream Public Health 240 N Broadway Portland OR 97214 421579435 501(c)(3) 50000 Water fluoridation Yamhill County 412 Ford St McMinnville OR 97128 936002318 Government 20000 Yamhill Cty Dental 9 0 Schedule I, Part I, Question 2 At the end of their funding cycle grantees are required to submit a final REPORT WHICH DELINEATES ACCOMPLISHMENTS RELATED TO STATED OBJECTIVES. LARGE GRANTS (TYPICALLY OVER $100,000) MAY REQUIRE QUARTERLY PROGRESS REPORTS. false true false false false false false true false Stephen Shawn Barton 0 211888 0 67709 0 3627 0 15728 0 14336 0 313288 0 0 Christine Cassel 0 184500 0 0 0 0 0 0 0 0 0 184500 0 0 Thomas Chapman 0 191695 0 0 0 0 0 89109 0 0 0 280804 0 0 Mark Charpentier 0 229819 0 150739 0 32842 0 71374 0 14336 0 499110 0 0 Mary Durham 0 200558 0 97418 0 34747 0 91932 0 14672 0 439327 0 0 Mark Enger 0 342634 0 187686 0 100689 0 92851 0 14672 0 738532 0 0 Daniel Garcia 0 562551 0 640000 0 26214 0 61308 0 12296 0 1302369 0 0 Eleanor Godfrey 0 183329 0 65555 0 31396 0 73555 0 14672 0 368507 0 0 William Graber 0 208269 0 0 0 0 0 0 0 0 0 208269 0 0 J Eugene Grigsby III 0 210900 0 0 0 0 0 0 0 0 0 210900 0 0 George Halvorson 0 1215613 0 5039506 0 1606796 0 61308 0 13287 0 7936510 0 0 Susan Hennessy 0 289806 0 162913 0 353131 0 279036 0 14672 0 1099558 0 286854 Judith Johansen 0 200075 0 0 0 0 0 0 0 0 0 200075 0 0 Michael Kinard 0 238195 0 76028 0 4831 0 60231 0 14672 0 393957 0 0 Kathryn Lancaster 0 630520 0 907953 0 570629 0 276632 0 12994 0 2398728 0 529003 Donna Lynne 0 476108 0 475000 0 363809 0 208108 0 14839 0 1537864 0 323554 Philip Marineau 0 200769 0 0 0 0 0 0 0 0 0 200769 0 0 Andrew McCulloch 0 388769 0 354518 0 75624 0 204811 0 14672 0 1038394 0 0 Thomas Meier 0 314471 0 339188 0 148588 0 97808 0 12994 0 913049 0 113944 Jenny Ming 0 179269 0 0 0 0 0 0 0 0 0 179269 0 0 Susan Mullaney 0 246093 0 50702 0 3503 0 25944 0 15287 0 341529 0 0 Donald Orndoff 0 376297 0 235328 0 22649 0 124482 0 13517 0 772273 0 0 Edward Pei 0 173000 0 0 0 0 0 16500 0 0 0 189500 0 0 J Neal Purcell 0 234858 0 0 0 0 0 0 0 0 0 234858 0 0 Karen Schartman 0 276793 0 118144 0 89755 0 73031 0 12994 0 570717 0 73895 Richie Smith 0 256676 0 81885 0 15979 0 55630 0 14950 0 425120 0 0 Arthur Southam 0 741374 0 1175000 0 732850 0 336623 0 12064 0 2997911 0 688121 Deborah Stokes 0 315132 0 337575 0 67595 0 105024 0 12994 0 838320 0 48521 Cynthia Telles 0 204613 0 0 0 0 0 0 0 0 0 204613 0 0 Bernard Tyson 0 892605 0 1290000 0 617691 0 469158 0 12994 0 3282448 0 587707 William Wiechmann 0 229977 0 110992 0 91566 0 64188 0 14672 0 511395 0 75817 Steven Zatkin 0 4500 0 542685 0 26936 0 66393 0 10532 0 651046 0 0 Victoria Zatkin 0 192675 0 85692 0 36401 0 82570 0 1961 0 399299 0 0 Mark Zemelman 0 398502 0 259500 0 120574 0 179338 0 12585 0 970499 0 80051 Schedule J, Part II Steven Zatkin- general council to 6/30/10; consultant 3/4/11 to present. Sandra Thompkins- board of directors to 4/1/11. Schedule J, line 3 kaiser foundation health plan of the northwest relied on kaiser foundation health plan, inc. that used one or more of the methods described below to establish the top management officials' compensation: - Compensation committee - Independent compensation consultant - form 990 of other organizations - written employment contract - compensation survey or study, and - approval by the board or compensation committee Schedule J, Line 4b George Halvorson $ 1,500,000 Bernard Tyson 587,707 Kathryn Lancaster 529,350 Thomas Meier 114,428 Arthur Southam 688,121 Deborah Stokes 48,521 Steven Zatkin 4,891 Mark Zemelman 81,133 Donna Lynne 323,554 William Wiechmann 75,817 Susan Hennessy 286,854 Karen Schartman 73,895 Some of the listed persons participated in nonqualified supplemental retirement plans. Under these plans, the organization makes annual contributions to accounts held in the name of individual participants. Contributions vary by position level and pay, and vest over time based on age and/or service. Participant accounts are credited with actual investment returns from up to four mutual funds and/or with a fixed rate of interest or a combination thereof. Unvested amounts are subject to risk of forfeiture. Schedule J, Line 7 The organization provided non-fixed payments to some of the persons listed. Payments were made under incentive plans, based on attainment of organizational performance goals and individual performance, designed to support the organization's mission to provide high-quality, affordable care and improve the health of its members and the communities it serves. Form 990, Part III, Lines 4a - 4d 2011 COMMUNITY BENEFIT REPORT KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST Kaiser Foundation Health Plan of the Northwest or "Northwest Health Plan" is a tax-exempt subsidiary health plan of Kaiser Foundation Health Plan, Inc. (KFHP). Northwest Health Plan as well as Kaiser Foundation Hospitals (KFH) are nonprofit corporations that are part of the integrated health care delivery system known as the Kaiser Permanente Medical Care Program or "Kaiser Permanente." In 2011, Northwest Health Plan served 480,386 medical members and another 195,673 dental members. Kaiser Permanente is an integrated health care delivery system that combines the provision and financing of health care services. People who elect to enroll in a Kaiser Permanente health plan receive a full range of prepaid health care services, including hospital care, professional care in hospitals and physicians' offices, x-ray and laboratory services, physical therapy, emergency, ambulance transportation, preventive services, health education, and certain prescribed drugs. More comprehensive drug coverage is also provided through a separate coverage rider. Membership in KFHP and its health plan subsidiaries is available without regard to sex, race, religion, ethnic background, sexual orientation, occupational status, or income level. Health Plan members are broadly representative of the various ages, social, and income groups within the areas served. Once enrolled, a member is free to maintain membership regardless of age, health status or employment. KAISER PERMANENTE'S COMMITMENT TO THE COMMUNITY Kaiser Permanente believes its Direct Community Benefit Investment (DCBI), is fundamental to being a nonprofit organization. It embodies the organization's commitment to improve the health of communities beyond services to Health Plan members. It is more than traditional corporate citizenship or corporate philanthropy. It is an intentional, planned, budgeted, measurable, accountable creation for better health in our communities. It is done in collaboration with, not in isolation from, the community. DCBI serves to fulfill Kaiser Permanente's social purpose, justify its tax-exempt status, and differentiate it from other health care organizations. This tradition of community benefit dates from the earliest days of the Program, when charitable care to non-employees, and later, nonmembers, was initiated. That heritage has continued through the years in Kaiser Permanente's early participation in publicly financed programs such as Medicaid and Medicare, establishment of residency training and medical research programs, and later, in the development of the Educational Theatre Programs, Safety Net Partnerships, Community Health Initiatives and Charitable Health Coverage Programs. In 2007, the KFHP/H Board of Directors refined the focus of the organization's Community Benefit Program and established the following four priority areas which have come to be known as "streams of work": - Care and Coverage for Low-Income People - Creates and supports programs that lower the financial barriers for the under- and uninsured. - Community Health Initiatives - Designs, delivers, and sustains long-term programs that engage communities in work to improve conditions in their neighborhoods. - Safety Net Partnerships - Builds partnerships with community clinics, local health departments, and public hospitals. Provides funding, technical assistance, dissemination of care management and quality improvements technology to help improve care and expand treatment capacity for vulnerable populations. - Developing and Disseminating Knowledge - Improves health care by sharing our knowledge- educating practitioners, advancing research, empowering consumers and informing policymakers about the evidence base for care and health. The Board elaborated that at least 75% of total community benefit funding will be directed to program priorities within the four streams of work and the remaining 25% of funding will be directed by local regions to respond to local community benefit needs and opportunities that may or may not be within the four priority areas. THE COMMUNITY BENEFIT PROGRAM IN THE NORTHWEST REGION In 2011, Northwest Health Plan expended $51.9 million to support Community Benefit activities. A breakdown of the 2011 Community Benefit dollars attributable to Northwest Health Plan in Oregon and Washington is described in Attachment A. The following identifies many of the signature community benefit programs and services grouped according to the national streams of work funded by Northwest Health Plan in Oregon and Washington. CARE AND COVERAGE FOR LOW-INCOME PEOPLE There are roughly 49 million people in America without access to health care or coverage. Uninsured, low-income individuals and families who are not eligible for public programs often have to rely on traditional charity care. Frequently, individuals in this situation may wait to seek medical care until their conditions become critical, and end up in hospital emergency rooms for treatment of conditions that are preventable or easily treated in earlier stages. In 2011, Health Plan in the Northwest spent approximately $51 million to address the financing and delivery of health care for populations vulnerable due to socio-economic status, illness, ethnicity, age or other factors. Program beneficiaries (under- and uninsured) received free or discounted care in a Kaiser Permanente facility or by a Kaiser Permanente provider. Charitable Care (Financial Assistance Program and Charitable Health Coverage) In Oregon and Washington, Northwest Health Plan provided charity care to low-income vulnerable populations through the Financial Assistance and Charitable Health Coverage Programs. In 2011, the Northwest Health Plan spent $15 million to serve under- and uninsured residents in Oregon and Washington. Financial Assistance Program This program helps pay the medical and dental expenses of patients, both member and nonmember, who meet qualifying guidelines by paying for services at facilities owned and/or operated by the Northwest Health Plan. The length of financial assistance is based on individual need. At the end of the financial assistance award period, the patient may apply for an extension. Kaiser Permanente's charity care program also includes discounted charges for uninsured patients below 400% of the federal poverty guidelines. In 2011, Northwest Health Plan spent $8.0 million and served 5,328 applicants who qualified for medical assistance or the uninsured discount. Charitable Coverage Program Charitable Health Coverage (CHC) is a unique approach to caring for low-income uninsured persons in the community. Participants receive a regular Kaiser Permanente membership card and access to the full range of our service and providers-a much better alternative to a brief and costly emergency room visit or hospitalization. This allows us to invest in the longer term health of patients and the community. Since inception in the early 1980s, CHC programs have made a real difference in the lives of persons who might otherwise have no other source of care. The Northwest Health Plan provided coverage and services valued at $7.5 million to provide subsidized coverage to more than 4,500 low-income adults and children who are not eligible for standard Medicaid or privately funded coverage. The Charitable Health Coverage Program consists of Transitions, Child Health Plan, and Washington Basic Health. - Transitions - The Transitions Program is a fully subsidized health insurance program for eligible low-income families. Eight college campuses currently participate within the Portland Metropolitan area. Students must be enrolled in a participating school, meet financial criterion, and cannot be enrolled in another private or public health care plan. Graduates are eligible for an additional six months coverage or until employer-paid coverage is activated. (not to exceed 48 months). - Child Health Plan -The Child Health Program is a fully subsidized health insurance program for eligible low-income students. 397 schools currently participate within the Multnomah Education Service District, Salem-Keizer School District and Hillsboro School District, Beaverton School District and Clackamas School District. Students must be enrolled in a participating school, meet financial criterion, and cannot be enrolled in another private or public health care plan. The participating school districts act as the administrator for the program and are responsible for outreach, eligibility determination and enrollment. Participation in Medicaid and Other Government-Sponsored Programs The Northwest Health Plan provided coverage and services valued at $13.4 million (in excess of reimbursement) for members and nonmembers in government-sponsored programs. Medicaid Member Programs The Northwest Health Plan participated in three Medicaid programs in Oregon and Washington. The following describe the programs and target populations. - Oregon Health Plan - Northwest Health Plan receives monthly capitated premiums from the Division of Medical Assistance Program (DMAP). Members are enrolled based on eligibility criteria. Health Plan provides services to eligible participants who reside in Clackamas, Multnomah, Polk, and Marion counties. - Healthy Options - Healthy Options is a Medicaid program for low income individuals that meet eligibility guidelines for Medicaid. It is a state program managed by the Washington State Health Care Authority (HCA). Kaiser Permanente provides services to eligible participants who reside in either Clark or Cowlitz counties. Medicaid to Nonmembers Northwest Health Plan contributed $ 0.9 million in subsidized care to Medicaid Fee-for-Service patients. When a Medicaid nonmember receives services from Kaiser Permanente providers at contract hospitals or outpatient services as a result of hospital visit follow-up, or in-patient services for Medicaid members in Oregon, these expenses are recorded as non-capitated services and are reported as professional and non-professional losses for Medicaid nonmembers. Other Government Programs The Oregon and Washington Medical Insurance Pools are insurance pools for the States of Oregon and Washington for individuals who do not have access to individual insurance due to pre-existing conditions that disqualify them from other group plans. Legislation allows the states to spread a portion of the program expenses for enrollees across the individuals who are insured wholly or in part by all health insurers, re-insurers and stop-loss carriers licensed in the state. COMMUNITY HEALTH INITIATIVES As an innovator in health, Kaiser Permanente designs, delivers and sustains long-term programs that engage communities in work to improve conditions in their neighborhoods, workplaces and schools to support good health, particularly Healthy Eating, Active Living (HEAL). In 2011 the Northwest Health Plan provided human and in-kind support to more than 15 nonprofit organizations. SAFETY NET PARTNERSHIPS Through funding, technical assistance, public policy advocacy, training and volunteering, dissemination of care-management and quality improvement technologies, Kaiser Permanente helps these vital health care providers improve care and expand treatment capacity for the communities and vulnerable people they serve. During 2011, Northwest Health Plan provided staff and in-kind support to more than 22 nonprofit safety net organizations. - CareOregon Community Health received a $50,000 grant to support the Oral Health Initiative in Clackamas County. - Upstream Public Health received a $50,000 grant to support water fluoridation. - Yamhill County received a $50,000 grant to support the Yamhill County Dental Health Project. OTHER COMMUNITY BENEFITS The Northwest Health Plan expended more than $229 thousand on community benefits activities and programs beyond the national streams of work. ATTACHMENT A 2011 COMMUNITY BENEFIT INVESTMENT - NORTHWEST HEALTH PLAN The following chart summarizes 2011 Community Benefit investments in Oregon and Washington States Health Plan. The investments in the community reflected in the chart are unaudited. CARE AND COVERAGE Charitable Care & Coverage Programs $ 15,446,124 Government Sponsored Program 34,474,704 Care & Coverage CB Operations 1,450,527 Subtotal: $ 51,371,355 COMMUNITY HEALTH INITIATIVES Community Health Initiatives CB Operations $ 402 Subtotal: $ 402 SAFETY NET PARTNERSHIPS Grants/Donations for Safety Net Partnerships $ 220,000 Safety Net CB Operations 28,561 Subtotal: $ 248,561 KNOWLEDGE DISSEMINATION Knowledge Dissemination CB Operations $ 18,630 Subtotal: $ 18,630 OTHER COMMUNITY BENEFITS Grants/Donations for Other Community Benefits $ 117,945 Other CB Operations 111,292 Subtotal: $ 229,237 TOTAL $ 51,868,185 Form 990, Part VI, Question 4 On March 3, 2011, Article E., Officers, of the Bylaws of the Corporation was amended on March 3, 2011 to (a) provide that the officers of the Corporation may include one or more Group Presidents (Section E-1, Officers); (b) add a new Section E-8, Group President and/or Regional President, to describe the duties and responsibilities of those positions; (c) provide that the President shall be the Chief Operating Officer of the Corporation (Section E-7); (d) provide clarification regarding leadership in the event of the absence or disability of the President (Section D-9, Executive Vice President or National Senior Vice President); and (e) change the reference to "the President" in Sections E-3, E-4 and E-11 to "any President"; and On June 23, 2011, minor technical amendments were made to the Bylaws of the Corporation to make them more consistent with the Bylaws of Kaiser Foundation Health Plan, Inc. and its Health Plan subsidiaries and with organizational policies and current law. None of the changes were significant; and On December 1, 2011, Article A, Purpose, of the Bylaws of the Corporation was amended to (a) more clearly state the purposes in one Purpose section (A-1, former section A-2 was deleted); (b) expressly state that the corporation is prohibited from engaging in activities not permitted by Section 501(c)(3) of the Internal Revenue Code and to specifically state that the corporation shall not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office (Section A-3 Nonprofit Character - now A-2); (c) make a reference to the Internal Revenue Code consistent with other references in the Bylaws (Section A-4 Disposition of Assets on Liquidation or Dissolution - now A-3); and (d) be consistent with current legal standards (Section A-5 Non-discrimination - now A-4). Form 990, Part VI, Question 6 Kaiser foundation health plan, inc is the sole member. Form 990, Part VI, Questions 7a KFHP appoints the directors (and fills vacancies and has authority to remove directors). The same 14 individuals who comprise the board of directors of KFHP also serve as the 14 directors of KFHP-CO, OH, NW, MAS Form 990, Part VI, Question 7b THE FOLLOWING ACTIONS OF THE CORPORATION REQUIRE APPROVAL OF THE SOLE MEMBER: A) REMOVAL OF THE CHAIRMAN OF THE BOARD OR ANY PRESIDENT; B) Amendment of article d, section d-4 of the bylaws - election and term of office of directors Form 990, Part VI, Question 11b form 990 review process 1. Key information necessary for the preparation of the tax return is obtained and/or confirmed with internal sources including regional finance, executive compensation, community benefits, treasury, government relations, and legal. 2. Community benefits details are presented to the community benefit committee of the board for review. 3. Executive compensation details are presented to the compensation committee of the board for review. 4. The complete tax return is reviewed and signed by a Pricewaterhousecoopers tax advisor. 5. The complete tax return is reviewed and signed by an officer or a member of management designated by an officer. 6. The tax return is discussed with the full board of directors. A copy of the return is provided to each board member in electronic format prior to filing. Form 990, Part VI, Questions 12c Regularly and Consistently Monitors Compliance with the Conflicts of Interest Policy Kaiser Permanente regularly monitors compliance with the Conflicts of Interest Policy in 3 key ways: 1. The Kaiser Permanente Compliance Hotline is available to all employees and vendors to report actual or potential conflicts of interest. All calls are answered by a third party and provided to Kaiser Permanente's National Compliance office for review and appropriate action. Employees can report anonymously and without fear of retaliation. Reports of actual or potential Conflicts of Interest are generated and investigations are conducted as required and information is tracked and trended to determine if additional guidance is required to avoid conflicts of interest. Compliance Hotline Reports are provided for review and action to the Kaiser Foundation Health Plan/ Hospitals Boards of Directors annually. 2. The Chief Compliance Officer and the VP of Internal Audit Services annually review the directors', officers', key employees', and executives' Annual Conflicts of Interest Questionnaire disclosures and provide direction on any investigations required. Investigations are documented, tracked and trended to determine if additional controls or education is required; In addition, Conflicts of Interest Questionnaire Reports are provided for review and action to the Kaiser Foundation Health Plan/ Hospitals Boards of Directors annually; and 3. Annually, as a component of the external audit, KPMG reviews the Annual Conflicts of Interest Questionnaires completed by Directors, Officers, Key Employees, and Executives, and actions taken as a result of the disclosures. The results of the annual audit, including any findings in this area are presented to the Kaiser Foundation Health Plan/ Hospitals Audit and Compliance Committee. Regularly and Consistently Enforces Compliance with the Conflicts of Interest Policy To ensure consistency in the enforcement of the policy Kaiser Permanente uses the following steps as a general guideline: A. Represented employees are subject to any corrective/disciplinary action provisions described in specific regional/national collective bargaining agreements and/or organizational policies and practices. B. Kaiser Permanente notifies employees of the National Human Resources Policy No. 14. Corrective/Disciplinary Action Policy during new employee orientation and in annual compliance training. C. In the event that it is necessary to discipline any employee because of, but not limited to, failure to comply with applicable legal/regulatory requirements, Kaiser Permanente policies and procedures, or the Principles of Responsibility, or for unsatisfactory performance or misconduct, coaching/counseling and/or corrective/disciplinary action may include, but is not limited to: (I) Oral discussion and/or warning by the employee's immediate supervisor or higher level manager to correct the problem (II) Written notice, with or without final warning (III) Paid or unpaid suspension, with or without final warning (IV) Termination of employment Form 990, Part VI, Question 15a/b The executive compensation program is designed to recruit, retain and motivate qualified senior management personnel. Senior management personnel have a significant impact on the strategic and policy direction and results of the organization. Therefore, the executive compensation program is, to a significant degree, performance-based. The compensation program is reviewed annually by the Compensation Committee of the Board of Directors which evaluates and approves, prior to payment, all programs and payments to CEO, Executive Director and top management officials (executives). Base pay for executive positions is established at a level comparable to the relevant market. In addition, other components of the compensation program bear 'at-risk' features designed to focus on strategically important performance goals and to assist in attracting and retaining top performers. The executive compensation program is targeted at the median of the comparable external market in which the organization competes for executive leadership. Evaluation of comparable pay data is performed by an Independent Compensation, Benefit & Human Resource Consulting firm. The compensation program focuses on objectives in the areas of quality of member care and service, financial soundness, and the community and social mission of the organization. Form 990, Part VI, Question 19 Governing documents - are available as provided to state Dept. of Insurance and maintained on state agency website or upon request. COI is available on KP website under vendor Principles of Responsibility or upon request. Financial Statements are on file with state insurance agency on a statutory basis (stand alone entity). Combined data is published for Kaiser Foundation Health Plan Inc. and subsidiaries and Kaiser Foundation Hospitals and Subsidiaries with audit opinion by KPMG and is available upon request. To request copies contact: VP - National Tax Compliance Kaiser Foundation Health Plan and Hospitals One Kaiser Plaza, 15L Oakland, CA 94612 Form 990, Part VII, Section A, Column B Individuals who are both officers and members of Boards of Directors work full time as employees as well as fulfill their board assignment. All officers work full time in their employee capacity. Full time work may require in excess of the traditional 40 hour week. Given the integrated nature of our organization, employees may provide support for various Kaiser Permanente companies. The average hours per week reported for the filing organization and related organizations was estimated. Form 990, Part XI, Line 5 Change in Other Comprehensive Income $ (131,015,961) Change in Unrealized Gain/Loss (2,800,671) Gain/loss on sale of investments - tax (3,509,271) Gain/loss on sale of investments - book 4,954,272 Other than temporary impairment loss (2,550,943) TOTAL $ (134,922,574) HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Christine Cassel TITLE:Director HOURS:7 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Thomas Chapman TITLE:Director HOURS:10 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Daniel Garcia TITLE:SVP, Chief Compliance Officer HOURS:48 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:William Graber TITLE:Director HOURS:8 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:J. Eugene Grigsby III TITLE:Director HOURS:7 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:George Halvorson TITLE:Chairman and CEO HOURS:45 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Judith Johansen TITLE:Director HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Kim J. Kaiser TITLE:Director HOURS:8 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Philip Marineau TITLE:Director HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Jenny Ming TITLE:Director HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Edward Pei TITLE:Director HOURS:8 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Margaret Porfido TITLE:Director HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:J. Neal Purcell TITLE:Director HOURS:9 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Cynthia Telles TITLE:Director HOURS:7 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Sandra Thompkins TITLE:Director HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Kathryn Lancaster TITLE:EVP & CFO HOURS:46 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Donna Lynne TITLE:Group President & Region Pres. HOURS:46 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Andrew McCulloch TITLE:Region President - Northwest HOURS:25 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Thomas Meier TITLE:SVP, Corporate Treasurer HOURS:47 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Donald Orndoff TITLE:SVP, NFS HOURS:45 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Arthur Southam TITLE:EVP, HP Operations HOURS:45 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Deborah Stokes TITLE:SVP, CC & CAO HOURS:46 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Bernard Tyson TITLE:President & COO HOURS:45 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:William Wiechmann TITLE:VP, Regional Counsel - NW HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Victoria Zatkin TITLE:VP, Off of Brd & Corp Gov Svcs HOURS:46 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mark Zemelman TITLE:SVP, Gen Counsel & Secretary HOURS:47 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mark Charpentier TITLE:VP, Mktg, Sls & Bus Devel HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mark Enger TITLE:VP, Chief Operations Officer HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Susan Hennessy TITLE:VP, Strategic Planning & Hlth HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Susan Mullaney TITLE:Hospital Admin - Sunnyside HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Karen Schartman TITLE:VP & CFO HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Stephen Shawn Barton TITLE:Exec Dir, Revenue Cycle - NW HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mary Durham TITLE:VP, The Center Health Research HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Eleanor Godfrey TITLE:VP, Quality & Service HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Michael Kinard TITLE:Ambulatory Care Svc Leader HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Richie Smith TITLE:VP, HR - NW HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Steven Zatkin TITLE:Consultant HOURS: Kaiser Permanente Oregon Plus LLC ONE KAISER PLAZA 15L OAKLAND CA 94612 202396517 HEALTH CARE OR 0 0 na Kaiser Foundation Health Plan Inc ONE KAISER PLAZA 15L OAKLAND CA 94612 941340523 HEALTH CARE CA 501(c)(3) 9 NA false Kaiser Foundation Health Plan of CO Inc ONE KAISER PLAZA 15L OAKLAND CA 94612 840591617 HEALTH CARE CO 501(c)(3) 9 KFHP INC true Kaiser Foundation Health Plan of GA Inc ONE KAISER PLAZA 15L OAKLAND CA 94612 581592076 HEALTH CARE GA 501(c)(3) 9 KFHP INC true Kaiser Foundation Health Plan of the MAS ONE KAISER PLAZA 15L OAKLAND CA 94612 520954463 HEALTH CARE MD 501(c)(3) 9 KFHP INC true Kaiser Foundation Health Plan of OH Inc ONE KAISER PLAZA 15L OAKLAND CA 94612 340922268 HEALTH CARE OH 501(c)(3) 9 KFHP INC true Kaiser Foundation Hospitals ONE KAISER PLAZA 15L OAKLAND CA 94612 941105628 HEALTH CARE CA 501(c)(3) 3 KFHP INC true Camp Bowie Service Center ONE KAISER PLAZA 15L OAKLAND CA 94612 943299123 ADMIN CA 501(c)(3) 11 - 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