Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THIS ORGANIZATION IS MCLAREN HEALTH CARE CORPORATION. | |
| FORM 990, PART VI, SECTION A, LINE 7A | MCLAREN HEALTH CARE CORPORATION, THE HEALTH PLAN'S SOLE MEMBER, MAY ELECT TWO-THIRDS OF THE GOVERNING BODY. THE OTHER ONE-THIRD ARE REPRESENTATIVE ENROLLEES, WHO ARE ELECTED BY THE ENTIRE MEMBERSHIP OF MCLAREN HEALTH PLAN. | |
| FORM 990, PART VI, SECTION B, LINE 11 | FORM 990 IS REVIEWED BY MCLAREN HEALTH PLAN'S PRESIDENT & CEO AND ALSO BY THE CFO PRIOR TO FILING. AS PART OF AN INTEGRATED HEALTH SYSTEM, THE PARENT BOARD ALSO REVIEWS THE FORM 990. | |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH MCLAREN HEALTH PLAN BOARD MEMBER, OFFICER AND SENIOR MANAGEMENT EXECUTIVE COMPLETE THE MCLAREN HEALTH PLAN CONFLICT OF INTEREST DISCLOSURE FORM ANNUALLY. THE BOARD CHAIR AND PRESIDENT/CEO REVIEW ALL COMPLETED FORMS TO IDENTIFY ANY POTENTIAL CONFLICTS. ANY IDENTIFIED POTENTIAL CONFLICT IS INVESTIGATED AND RAISED WITH THE INDIVIDUAL, AS APPROPRIATE, TO RESOLVE THE CONFLICT OR DETERMINE IF ANY ACTION IS NEEDED, UP TO AND INCLUDING, POSSIBLE REMOVAL FROM THE BOARD, OR OFFICER/SENIOR MANAGEMENT POSITION. ANY IDENTIFIED CONFLICTS ARE REPORTED TO THE FULL BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION B, LINE 15 | TO ENSURE A FAIR, COMPETITIVE AND LEGALLY COMPLIANT METHOD OF ADMINISTERING COMPENSATION, MHP USES INDEPENDENT COMPENSATION STUDIES AND SURVEY DATA TO ESTABLISH THE COMPENSATION STRUCTURE FOR THE MHP CEO AND OFFICERS. COMPENSATION FOR THE CEO AND OFFICERS ARE REVIEWED ANNUALLY. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE PROVIDED UPON REQUEST. THE FINANCIAL STATEMENTS ARE AVAILABLE ON THE MICHIGAN OFIR WEBSITE. | |
| FORM 990, PART VII, SECTION A | THESE INDIVIDUALS DEVOTE THE FOLLOWING HOURS PER WEEK TO A RELATED ORGANIZATION FOR WHICH COMPENSATION IS REPORTED IN COLUMNS E & F: DON KOOY 40 HOURS MCLAREN HEALTH CARE CORPORATION KATHY KENDALL 40 HOURS MCLAREN HEALTH CARE CORPORATION DAVE MAZURKIEWICZ 40 HOURS MCLAREN HEALTH CARE CORPORATION RONALD SHAHEEN 40 HOURS MCLAREN HEALTH CARE CORPORATION KEVIN TOMPKINS 40 HOURS MCLAREN HEALTH CARE CORPORATION | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | FORM 990, PART XI, LINE 5: | NET UNREALIZED GAINS ON INVESTMENTS: 700,632. CHANGE IN NONADMITTED ASSETS 302,062. DIVIDEND PAID TO MEMBERS -11,000,000. TOTAL TO FORM 990, PART XI, LINE 5: -9,997,306. |
| FORM 990, PART IV, 12 AND FORM 990 PART XII,2: | THE ORGANIZATION OBTAINED A SEPARATE, INDEPENDENT AUDITED FINANCIAL STATEMENT FOR THE TAX YEAR ON AN OCBOA STATUTORY ACCOUNTING METHOD. |
| Software ID: | |
| Software Version: |