Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| BOARD MEMBER INDEPENDENCE | FORM 990, PART VI, SECTION A, LINE 1B | Bradford Rich, a trustee of SelectHealth, Inc., is also the chief financial officer of SkyWest Airlines ("SkyWest"). SkyWest has a contractual relationship with the public company, Delta Air Lines ("Delta") pursuant to which it serves as a Delta local carrier. Therefore, although SelectHealth's travel reservations and purchases are booked through Delta Air Lines, many of the local flights by SelectHealth employees are on SkyWest airplanes. Since SelectHealth's transactions are directly with Delta and not SkyWest, Mr. Rich has been reported as independent on the Form 990, Part VI, Line 1b. ********** IN ADDITION TO SERVING ON THE FILING ORGANIZATION'S BOARD, EACH SELECTHEALTH TRUSTEE WAS ALSO A DIRECTOR OF THE SELECTHEALTH BENEFIT ASSURANCE COMPANY ("SHBAC"), A WHOLLY-OWNED TAXABLE SUBSIDIARY. DURING 2010, SHBAC PURCHASED ADMINISTRATIVE SERVICES FROM THE FILING ORGANIZATION. SEE SCHEDULE R, PART V. NO FINANCIAL BENEFIT CAN OR DOES ACCRUE TO THE TRUSTEES AS A RESULT OF THEIR SERVICE ON BOTH BOARDS. THEREFORE, THE INDEPENDENCE STATUS OF THE FILING ORGANIZATION'S TRUSTEES HAS NOT BEEN AFFECTED BY THIS RELATIONSHIP. |
| BUSINESS AND FAMILY RELATIONSHIPS | FORM 990, PART VI, SECTION A, LINE 2 | ALBERT R. ZIMMERLI / BARBARA J. RAY / BRADFORD R. RICH / CHARLES W. SORENSON JR MD / DANIEL G. GOMEZ / DIANE T. NAYLOR / EDWARD G. KLEYN / H. DON NORTON / KEVEN J. JENSEN / MARK R. BRIESACHER MD / MICHAEL M. SMITH / PATRICIA R RICHARDS / STEPHEN W. WADE / THOMAS B. MORGAN / VERNON J. COOLEY - BUSINESS RELATIONSHIP (BOARD MEMBERS OF SELECT HEALTH BENEFIT ASSURANCE COMPANY, A TAXABLE ORGANIZATION THAT IS WHOLLY-OWNED BY THE FILING ORGANIZATION) ALBERT R. ZIMMERLI / CHARLES W. SORENSON JR MD - BUSINESS RELATIONSHIP (BOARD MEMBERS AND OFFICERS OF AFFILIATED SERVICES, INC., A TAXABLE CORPORATION WITH MINIMAL ACTIVITY THAT IS WHOLLY-OWNED BY THE FILING ORGANIZATION'S PARENT.) ALBERT R. ZIMMERLI / CHARLES W. SORENSON JR MD - BUSINESS RELATIONSHIP (BOARD MEMBERS AND OFFICERS OF THE HEALTHCARE CAPTIVE INSURANCE COMPANY, A TAXABLE CORPORATION THAT IS WHOLLY-OWNED BY THE FILING ORGANIZATON'S PARENT.) KEVEN J. JENSEN / THOMAS B. MORGAN - FAMILY RELATIONSHIP CHARLES W SORENSON JR, MD / ALBERT R ZIMMERLI / MARK R BRIESACHER, MD - BUSINESS RELATIONSHIP (EMPLOYER/EMPLOYEE RELATIONSHIPS IN A RELATED TAX EXEMPT ORGANIZATION) |
| ORGANIZATION MEMBER | FORM 990, PART VI, SECTION A, LINES 6 & 7 | The sole member of SelectHealth, Inc. is Intermountain Health Care, Inc., a Utah nonprofit corporation. Pursuant to the approved bylaws, the member exercises all property, voting, and other rights, interests and powers conferred under local statute, including the election of SelectHealth's trustees. |
| FORM 990 REVIEW BY BOARD MEMBERS | FORM 990, PART VI, SECTION B, LINE 11 | The Board of Trustees delegated the initial detailed review of the Form 990 to the Audit Committee. Draft copies of the return were presented to the Committee in advance of its fall meeting. The return was discussed in depth and questions were answered during that meeting. Unresolved issues were corrected prior to finalization and submission of the form. Prior to filing, a copy of the final return was provided to each member of the Board of Trustees. |
| MONITORING AND ENFORCEMENT OF THE CONFLICT OF INTEREST POLICY | FORM 990, PART VI, SECTION B, LINE 12 | Each officer, director, trustee, and key employee is required to complete the Conflict of Interest questionnaire at least annually. These individuals have also been instructed to update their questionnaire information if they become aware of a new potential conflict, or if any of the previously reported information changes. The questionnaires are collected and reviewed, per policy, by IHC Health Services' Vice President of Business Ethics and Compliance. Potential conflicts of interest are reviewed with appropriate personnel, which may include (but is not limited to) the Audit Committee Chair, Senior Management, and the Legal Department. IF AN INDIVIDUAL DISCLOSES A SITUATION THAT POSES A CONFLICT OF INTEREST, A DETERMINATION IS MADE WHETHER THE SITUATION CAN BE MANAGED (SUCH AS BY RECUSAL IN DECISION-MAKING SETTINGS) OR MUST BE ELIMINATED (SUCH AS THROUGH DIVESTITURE OF THE OUTSIDE INTEREST OR REQUIRING A CHOICE BETWEEN THE INDIVIDUAL'S ROLE WITH SELECTHEALTH OR THE OUTSIDE ENTITY). Findings are reported to the full Audit Committee. |
| EXECUTIVE COMPENSATION | FORM 990, PART VI, SECTION B, LINE 15 | The Executive Compensation Committee ("Committee") of Intermountain Health Care, Inc. is responsible for the process of annually determining the total compensation package for the SelectHealth President / Chief Executive Officer. Pursuant to Intermountain Health Care's written "Compensation Philosophy," the Committee annually retains an independent, external consulting firm to provide an analysis of valid, comparable data. The consultants review the various types of direct compensation, including base salary, total cash, as well as annual and long term incentives. Information from a selected group of comparable not-for-profit organizations is used to supplement published survey data. The consultants also conduct an in-depth analysis of the associated benefits and perquisites. Information provided by the external consultants is reviewed by the Committee along with the performance data for the individual listed above. Decisions by the Committee are contemporaneously documented. The Committee reviews all of the collected information and the associated pay decisions with the entire board of trustees. The Executive Committee of the filing organization is responsible for reviewing and approving the compensation packages for the remaining SelectHealth officers. Adjustments in compensation are based on current market information and changes in job responsibility. |
| PUBLIC INSPECTION OF GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STMTS. | FORM 990, PART VI, SECTION C, LINE 19 | SelectHealth does not currently allow public inspection of its governing documents, conflict of interest policy, or financial statements. |
| RECONCILIATION OF NET ASSETS | FORM 990, PART XI, LINE 5 | OTHER CHANGES IN FUND BALANCE: - $27,418,642 NET UNREALIZED GAINS ON INVESTMENTS - ($1,500,000) PENSION FUNDING ASSESSMENT. |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:ALBERT R ZIMMERLI TITLE:TRUSTEE HOURS:65 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:BARBARA J RAY TITLE:VICE CHAIR/SEC/TRUSTEE HOURS:5 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:BRADFORD R RICH TITLE:TRUSTEE HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:CHARLES W SORENSON JR MD TITLE:TRUSTEE HOURS:68 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:DANIEL G GOMEZ TITLE:TRUSTEE HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:DIANE T NAYLOR TITLE:TRUSTEE HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:EDWARD G KLEYN TITLE:TRUSTEE HOURS:3 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:H DON NORTON TITLE:TRUSTEE HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:KEVEN J JENSEN TITLE:TRUSTEE HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:MARK R BRIESACHER MD TITLE:TRUSTEE HOURS:53 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:MICHAEL M SMITH TITLE:TRUSTEE HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:PATRICIA R RICHARDS TITLE:PRESIDENT/CEO/TRUSTEE HOURS:10 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:STEPHEN W WADE TITLE:TRUSTEE HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:THOMAS B MORGAN TITLE:TRUSTEE / CHAIR HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:VERNON J COOLEY MD TITLE:TRUSTEE HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:DAVID H OLSON TITLE:OUTGOING VICE PRESIDENT HOURS:5 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:J MURPHY WINFIELD TITLE:VICE PRESIDENT HOURS:5 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JERRY EDGINGTON TITLE:VICE PRESIDENT HOURS:5 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:LISA K FALLERT TITLE:VICE PRESIDENT/SECRETARY HOURS:5 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:MARK BROWN TITLE:VICE PRESIDENT/CFO/TRESURER HOURS:5 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:ROBERT WHITE TITLE:VICE PRESIDENT/CIO HOURS:5 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:STEPHEN L BARLOW MD TITLE:VICE PRESIDENT/CMO HOURS:5 |
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