Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 01-01-2010 and ending 12-31-2010
BCheck if applicable:
CName of organization
KAISER FOUNDATION HEALTH PLAN
OF THE NORTHWEST
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
ONE KAISER PLAZA 15L
 
Room/suite
City or town, state or country, and ZIP + 4
OAKLAND, CA94612
D Employer identification number

93-0798039
E Telephone number

G Gross receipts $ 3,064,231,479
F Name and address of principal officer:
ANDREW R MUCULLOCH
ONE KAISER PLAZA 15L
OAKLAND,CA94612
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
N/A
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1984
M State of legal domicile: OR
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: To provide high-quality, affordable health care services to improve the health of our members and the communities we serve.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 14
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 12
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 7,796
6 Total number of volunteers (estimate if necessary) .... 6 89
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 1,259,102
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 0 56,498
9 Program service revenue (Part VIII, line 2g) ......... 2,573,087,902 2,682,950,846
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 27,845,955 29,927,694
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 17,454,082 13,216,018
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 2,618,387,939 2,726,151,056
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 472,273 338,109
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 603,491,060 661,685,670
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 1,990,874,462 2,042,758,098
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 2,594,837,795 2,704,781,877
19 Revenue less expenses. Subtract line 18 from line 12...... 23,550,144 21,369,179
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 1,015,109,362 1,024,197,650
21 Total liabilities (Part X, line 26)............ 866,422,827 941,102,794
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 148,686,535 83,094,856
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: TO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 2,500,661,294 including grants of $ 72,049 ) (Revenue $ 2,660,667,147 )
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.
4b (Code:   ) (Expenses $ 60,452,789 including grants of $ 0 ) (Revenue $ 21,024,597 )
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 2010, Northwest Health Plan participated in a number of government programs. Medicaid Managed Care - providing comprehensive care for more than 7,679 managed care members, Medicaid Fee for Service and the State Children's Health Initiative - providing comprehensive health benefits, including dental and vision care to more than 7,654 patients.
4c (Code:   ) (Expenses $ 25,375,034 including grants of $ 0 ) (Revenue $ 0 )
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 5,428 patients received comprehensive care for up to four years through these programs.
(Code:   ) (Expenses $ 1,287,708 including grants of $ 266,060 ) (Revenue $ 0 )
SEE SCHEDULE O COMMUNITY BENEFIT REPORT
4d Other program services. (Describe in Schedule O.)
(Expenses $ 1,287,708 including grants of $ 266,060 ) (Revenue $ 0 )
4e Total program service expensesMediumBullet$ 2,587,776,825
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
 
No
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
Yes
 
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H.....
20a
 
No
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. .....
20b
 
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II........................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III............... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
4,106
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
7,796
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
14
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
12
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
OR , WA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
VP - NATIONAL TAX COMPLIANCE
ONE KAISER PLAZA 15L
OAKLAND,CA94612
(510) 271-6385
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) CHRISTINE K CASSEL MD
DIRECTOR
 .5 X           0 172,625 0
(2) THOMAS W CHAPMAN EDD
DIRECTOR
 1.0 X           0 185,427 59,810
(3) DANIEL P GARCIA
SVP, Chief Compliance Officer
 2.0 X           0 1,280,238 73,787
(4) WILLIAM R GRABER
DIRECTOR
 1.0 X           0 232,123 0
(5) J EUGENE GRIGSBY III PHD
DIRECTOR
 1.0 X           0 193,743 0
(6) GEORGE C HALVORSON
Chairman, CEO, President
 5.0 X   X       0 7,667,335 76,092
(7) JUDITH A JOHANSEN
DIRECTOR
 .5 X           0 184,560 0
(8) KIM J KAISER
DIRECTOR
 .5 X           0 122,875 0
(9) PHILIP A MARINEAU
DIRECTOR
 .5 X           0 193,623 0
(10) JENNY J MING
DIRECTOR
 .3 X           0 182,748 0
(11) EDWARD PEI
DIRECTOR
 .5 X           0 168,250 16,500
(12) J NEAL PURCELL
DIRECTOR
 .5 X           0 219,738 0
(13) CYNTHIA A TELLES PHD
DIRECTOR
 .5 X           0 182,647 0
(14) SANDRA P THOMPKINS
DIRECTOR
 .5 X           0 166,951 0
(15) JENNIFER M GARDNER
Special Asst to BOD
 4.0     X       0 103,247 54,938
(16) KATHRYN LANCASTER
EVP & CFO
 4.0     X       0 1,558,076 296,474
(17) ANDREW R McCULLOCH
REGIONAL PRESIDENT - NW
 25.0     X       0 813,153 207,622
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) THOMAS R MEIER
SVP & TREASURER
 3.0     X       0 647,785 107,439
(19) DONALD ORNDOFF
SVP, NFS
 5.0     X       0 508,058 70,932
(20) ARTHUR M SOUTHAM MD
EVP - HEALTH PLAN OPERATIONS
 5.0     X       0 2,020,299 353,928
(21) DEBORAH STOKES
SVP, CORPORATE CONTROLLER, CAO
 4.0     X       0 622,642 123,860
(22) BERNARD J TYSON
President & COO
 5.0     X       0 1,942,514 359,961
(23) WILLIAM N WIECHMANN
VP, REGIONAL COUNSEL - NW
 50.0     X       0 365,887 75,641
(24) STEVEN ZATKIN
SVP, General Counsel & Secreta
 5.0     X       0 1,247,253 97,716
(25) VICTORIA ZATKIN
VP, Off of Brd & Corp Gov Svcs
 4.0     X       0 311,369 83,647
(26) MARK ZEMELMAN
SVP, General Counsel & Secreta
 4.0     X       0 806,199 150,636
(27) MARK CHARPENTIER
VP, Mktg, Sls & Bus Devel
 30.0       X     0 377,568 77,720
(28) MARK ENGER
VP, Chief Operations Officer
 30.0       X     0 533,013 103,085
(29) SUSAN HENNESSY
VP HEALTH PLAN SERVICES
 30.0       X     0 648,615 294,661
(30) SUSAN MULLANEY
HOSPITAL ADMINISTRATOR
 30.0       X     0 329,000 29,037
(31) KAREN SCHARTMAN
VP & CFO - NW
 30.0       X     0 402,595 86,708
(32) MARK BURMESTER
VP STRATEGIC PLANNING & COMM
 30.0         X   0 363,986 65,405
(33) MARY DURHAM
VP, The Center Health Research
 30.0         X   0 336,692 102,067
(34) MICHAEL THOMAS GRANT
VP HEALTH PLAN SERVICES ADMIN
 30.0         X   0 318,518 68,593
(35) MICHAEL KINARD
Ambulatory Care Svc Leader
 30.0         X   314,803 0 77,039
(36) RICHIE SMITH
VP, HR - NW
 30.0         X   0 301,337 58,604
(37) CHRISTINE MALCOLM
FORMER SVP
 0.0           X 0 568,721 12,021
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 314,803 26,279,410 3,183,923
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet696
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
NORTHWEST PERMANENTE PC
500 NE MULTNOMAH STREET
PORTLAND,OR97232 		MEDICAL SERVICES 417,542,110
PERMANENTE DENTAL ASSOCIATES
500 NE MULTNOMAH STREET
PORTLAND,OR97232 		DENTAL SERVICES 36,926,427
ST JOHN MEDICAL CENTER
1615 DELAWARE ST
LONGVIEW,WA98632 		HOSPITAL SERVICES 19,316,356
OREGON HEALTH SCIENCE UNIVERSITY
3181 SW SAM JACKSON PARK RD
PORTLAND,OR97239 		HOSPITAL SERVICES 26,062,917
KAISER FOUNDATION HOSPITALS
500 NE MULTNOMAH STREET
PORTLAND,OR97232 		HOSPITAL SERVICES 621,811,957
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet278
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		56,498
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 56,498
Program Service Revenue Business Code
2a MBR HLTH CARE PREM 621,400 1,909,112,446 1,909,112,446    
b SUPPL CHARGE/PHARM 621,400 137,469,644 136,210,542 1,259,102  
c NON-PLAN & IND REV 621,400 7,929,555 7,929,555    
d OTHER PRGRM SERV 621,400 26,628,751 26,628,751    
e MEDICARE 621,400 601,810,450 601,810,450    
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 2,682,950,846
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 21,957,911     21,957,911
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross Rents 629,781  
b Less: rental expenses 497,387  
c Rental income or (loss) 132,394  
d Net rental income or (loss).......MediumBullet 132,394     132,394
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 342,817,793 2,735,025
b Less: cost or other basis and sales expenses 334,632,348 2,950,688
c Gain or (loss) 8,185,445 -215,663
d Net gain or (loss)..........MediumBullet 7,969,783     7,969,783
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a MISC REVENUE 900,099 13,083,624     13,083,624
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 13,083,624
12 Total revenue. See Instructions....MediumBullet 2,726,151,056 2,681,691,744 1,259,102 43,143,712
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21 338,109 338,109
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 314,803 311,655 3,148  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 416,334,272 385,984,661 30,349,611  
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 56,125,255 56,125,255    
9 Other employee benefits ....... 155,866,007 139,697,306 16,168,701  
10 Payroll taxes ........... 33,045,333 33,045,333    
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 6,582   6,582  
c Accounting ........... 1,214,238   1,214,238  
d Lobbying ........... 262,103   262,103  
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 430,659   430,659  
g Other .......... 318,556,280 305,025,351 13,530,929  
12 Advertising and promotion .... 19,626,582 1,082,486 18,544,096  
13 Office expenses ....... 6,902,591 6,329,128 573,463  
14 Information technology ...... 131,298,023 113,257,338 18,040,685  
15 Royalties .. 0      
16 Occupancy ........... 19,699,540 19,673,188 26,352  
17 Travel ............ 3,086,718 2,779,383 307,335  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 209,820   209,820  
20 Interest ........... 5,635,356 5,635,356    
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 32,096,014 32,096,014    
23 Insurance .............. 10,212,868 10,212,868    
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a BASIC CONTRACT PAYMENTS 1,054,664,317 1,054,664,317    
b SUPPLIES 312,498,729 303,087,142 9,411,587  
c INTER-REGIONAL CHARGES 58,414,156 55,407,124 3,007,032  
d BUSINESS LICENSE & TAXES 17,964,617 17,964,562 55  
e EQUIPMENT RENTAL & MAINT 8,167,184 8,155,590 11,594  
f All other expenses 41,811,721 36,904,659 4,907,062  
25 Total functional expenses. Add lines 1 through 24f 2,704,781,877 2,587,776,825 117,005,052 0
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 4,588,886 1 5,377,638
2 Savings and temporary cash investments .......   2  
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net ......... 52,888,817 4 55,396,885
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 22,759,780 8 23,191,438
9 Prepaid expenses and deferred charges ............ 3,606,060 9 4,963,066
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 553,076,446
b Less: accumulated depreciation. ..... 10b 306,791,999 237,791,967 10c 246,284,447
11 Investments—publicly traded securities .......... 688,984,555 11 686,306,705
12 Investments—other securities. See Part IV, line 11 ......   12  
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 4,489,297 15 2,677,471
16 Total assets. Add lines 1 through 15 (must equal line 34)... 1,015,109,362 16 1,024,197,650
Liabilities 17 Accounts payable and accrued expenses . 153,035,241 17 142,589,262
18 Grants payable ..........   18  
19 Deferred revenue .......... 23,792,954 19 26,266,333
20 Tax-exempt bond liabilities ..........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 689,594,632 25 772,247,199
26 Total liabilities. Add lines 17 through 25..... 866,422,827 26 941,102,794
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .....   27  
28 Temporarily restricted net assets .....   28  
29 Permanently restricted net assets .....   29  
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ..... 4,712,722 30 4,712,722
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds 143,973,813 32 78,382,134
33 Total net assets or fund balances ..... 148,686,535 33 83,094,856
34 Total liabilities and net assets/fund balances ..... 1,015,109,362 34 1,024,197,650
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
2,726,151,056
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
2,704,781,877
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
21,369,179
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
148,686,535
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
-86,960,858
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
83,094,856
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
KAISER FOUNDATION HEALTH PLAN
OF THE NORTHWEST
Employer identification number

93-0798039
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .         56,498 56,498
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... 2,151,214,826 2,346,496,968 2,461,397,785 2,573,087,902 2,682,950,846 12,215,148,327
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5. 2,151,214,826 2,346,496,968 2,461,397,785 2,573,087,902 2,683,007,344 12,215,204,825
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)           12,215,204,825
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6... 2,151,214,826 2,346,496,968 2,461,397,785 2,573,087,902 2,683,007,344 12,215,204,825
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. 30,951,565 31,794,233 30,524,341 26,785,941 22,587,692 142,643,772
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b. 30,951,565 31,794,233 30,524,341 26,785,941 22,587,692 142,643,772
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.). 2,182,166,391 2,378,291,201 2,491,922,126 2,599,873,843 2,705,595,036 12,357,848,597
14
Section C. Computation of Public Support Percentage
15
15
98.846 %
16
16
98.681 %
Section D. Computation of Investment Income Percentage
17
17
1.154 %
18
18
1.320 %
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
The amounts reported on line 10a for 2008 and 2009 have been restated to include the amount of gross revenue from interest, dividends and similar sources. The form 990 as originally filed overstated the amount.
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
KAISER FOUNDATION HEALTH PLAN
OF THE NORTHWEST
Employer identification number

93-0798039
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
KAISER FOUNDATION HEALTH PLAN
OF THE NORTHWEST 		Employer identification number

93-0798039
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
KAISER FOUNDATION HEALTH PLAN
OF THE NORTHWEST 		Employer identification number

93-0798039
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
KAISER FOUNDATION HEALTH PLAN
OF THE NORTHWEST 		Employer identification number

93-0798039
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
KAISER FOUNDATION HEALTH PLAN
OF THE NORTHWEST
Employer identification number

93-0798039
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities ....................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2010

Schedule C (Form 990 or 990-EZ) 2010
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
Organization's
Totals 		(b) Affiliated Group
Totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots non-taxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2010


Schedule C (Form 990 or 990-EZ) 2010
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
193,184
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
Yes
 
28,409
i
Other activities? If "Yes," describe in Part IV ..........................
Yes
 
40,510
j
Total. lines 1c through 1i ...................................
262,103
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
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.
Schedule C (Form 990 or 990EZ) 2010

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
KAISER FOUNDATION HEALTH PLAN
OF THE NORTHWEST
Employer identification number

93-0798039
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance ....      
b Contributions ........      
c Investment earnings or losses ...      
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		     
f Administrative expenses ....      
g End of year balance ......      
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet  
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   39,283,592 39,283,592
b Buildings ................   373,977,714 227,160,635 146,817,079
c Leasehold improvements ............        
d Equipment ................   130,079,829 78,645,140 51,434,689
e Other .................   9,735,311 986,224 8,749,087
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 246,284,447
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes 0
RESERVE FOR SELF INSURED RISKS 2,183,200
RESERVE FOR PROF & PUBLIC LIAB 0
RESERVE FOR WORKERS COMP RISK 4,313,472
POST RETIREMENT BENEFIT-LT 743,143,018
POST RETIREMENT BENEFIT-CURRT 8,259,130
OTHER LIABILITIES & DEPOSITS 14,348,379



Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 772,247,199
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1 2,726,151,056
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 2,704,781,877
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 21,369,179
4 Net unrealized gains (losses) on investments .......................... 4 -6,332,067
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8 -80,628,792
9 Total adjustments (net). Add lines 4 - 8 ............................. 9 -86,960,859
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 -65,591,680
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 2,700,917,290
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d 14,553,612
e Add lines 2a through 2d ..................... 2e 14,553,612
3 Subtract line 2e from line 1..................... 3 2,686,363,678
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b 39,787,378
c Add lines 4a and 4b....................... 4c 39,787,378
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5 2,726,151,056
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 2,766,508,970
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c 6,332,067
d Other (Describe in Part XIV): ............ 2d 85,119,110
e Add lines 2a through 2d...................... 2e 91,451,177
3 Subtract line 2e from line 1..................... 3 2,675,057,793
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b 29,724,084
c Add lines 4a and 4b....................... 4c 29,724,084
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5 2,704,781,877
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
Schedule D, Part XI, Line 8   CHANGE IN OTHER COMPREHENSIVE INCOME $ (40,035,935) DIVIDENDS PAID (40,000,000) Gain on sale of investments - book 9,470,437 Gain on sale of investments - tax (8,185,445) see "note 1" (1,877,849) $ (80,628,792) 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 on sale of investments - book $ 9,470,437 rental expense reclass 497,387 Interentity revenue reclass 4,341,159 loss on fixed assets reclass 244,629 total $ 14,553,612
Schedule D, Part XII, Line 4b   Bad Debt expense reclass $ 10,574,925 Gain on sale of investments - tax 8,185,445 SEE PART XI, LINE 8, NOTE 1 1,877,849 INVESTMENT MANAGEMENT EXP RECLASS 430,659 Misc revenue reclass 18,718,500 total $ 39,787,378
Schedule D, Part XIII, Line 2d   CHANGE IN OTHER COMPREHENSIVE INCOME $ 40,035,936 DIVIDENDS PAID 40,000,000 rental expense reclass 497,387 Interentity revenue reclass 4,341,159 loss on fixed assets reclass 244,629 total $ 85,119,110
Schedule D, Part XIII, Line 4b   Bad Debt expense reclass $ 10,574,925 INVESTMENT MANAGEMENT EXP RECLASS 430,659 Misc revenue reclass 18,718,500 total $ 29,724,084
Schedule D, Part X, QUESTION 2   NOT REQUIRED
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
KAISER FOUNDATION HEALTH PLAN
OF THE NORTHWEST
Employer identification number
93-0798039
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) American Heart Association1200 NW Naito Parkway
Portland,OR97209 		13-5613797 501(c)(3) 26,820       Start! Greater Portland Heart & Stroke Walk 2010
(2) Canby School Distirct1130 S Ivy St
Canby,OR97013 		93-6000230 GOVT ENTITY 30,000       Canby Dental Health for Children and Youth Project
(3) Chemeketa Community College FoundationPO Box 14007
Salem,OR97309 		93-6097106 GOVT ENTITY 50,000       Circle of Smiles Campaign
(4) City of Hillsboro150 East Main St
Hillsboro,OR97124 		GOVT ENTITY 7,825       Celebrate Hillsboro 2010
(5) Coalition for a Livable Future107 SE Washington 239
Portland,OR97214 		93-1278845 501(c)(3) 9,125       Regional Livability Summit 2010
(6) Free Clinic of SW Washington4100 Plomondon Street
Vancouver,WA98661 		91-1707542 501(c)(3) 40,000       Adult Dental Program
(7) Oregon Center for Nursing5000 N Willamette Blvd
Portland,OR972035798 		74-3052430 501(c)(3) 11,500       Leadership at the Point of Care: The Critical Role
(8) Portland Schools Foundation2069 NE Hoyt St
Portland,OR97232 		93-1149789 501(c)(3) 9,600       2010 Portland Roast Festival
(9) Susan G Komen for the Cure Oregon & SW Washington1500 SW 1st Ave 270
Portland,OR97201 		93-1068897 501(c)(3) 14,950       Race for the Cure 2010
(10) United Way of the Columbia Willamette619 SW 11th Ave
Portland,OR97205 		93-0582124 501(c)(3) 7,500       Creston Children's Dental Center
(11) Upstream Public Health240 North Broadway
Portland,OR972145748 		42-1579435 501(c)(3) 20,000       Community Water Fluoridation Community Engagement


2
Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image
11
3
Enter total number of other organizations ................................ . Bullet Image
0
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2010

Schedule I (Form 990) 2010
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
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.
Schedule I (Form 990) 2010


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Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
KAISER FOUNDATION HEALTH PLAN
OF THE NORTHWEST
Employer identification number

93-0798039
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) MARK BURMESTER (i)
(ii)		 0
229,906 		0
104,860 		0
29,220 		0
51,865 		0
13,540 		0
429,391 		0
0
(2) CHRISTINE K CASSEL MD (i)
(ii)		 0
172,625 		0
0 		0
0 		0
0 		0
0 		0
172,625 		0
0
(3) THOMAS W CHAPMAN EDD (i)
(ii)		 0
185,427 		0
0 		0
0 		0
59,810 		0
0 		0
245,237 		0
0
(4) MARK CHARPENTIER (i)
(ii)		 0
236,937 		0
107,855 		0
32,776 		0
65,062 		0
12,658 		0
455,288 		0
0
(5) MARY DURHAM (i)
(ii)		 0
206,955 		0
95,203 		0
34,534 		0
89,073 		0
12,994 		0
438,759 		0
0
(6) MARK ENGER (i)
(ii)		 0
335,545 		0
159,659 		0
37,809 		0
90,091 		0
12,994 		0
636,098 		0
0
(7) DANIEL P GARCIA (i)
(ii)		 0
517,930 		0
585,000 		0
177,308 		0
62,481 		0
11,306 		0
1,354,025 		0
151,518
(8) JENNIFER M GARDNER (i)
(ii)		 0
95,718 		0
6,040 		0
1,489 		0
41,870 		0
13,068 		0
158,185 		0
0
(9) WILLIAM R GRABER (i)
(ii)		 0
232,123 		0
0 		0
0 		0
0 		0
0 		0
232,123 		0
0
(10) MICHAEL THOMAS GRANT (i)
(ii)		 0
201,403 		0
96,930 		0
20,185 		0
55,053 		0
13,540 		0
387,111 		0
0
(11) J EUGENE GRIGSBY III PHD (i)
(ii)		 0
193,743 		0
0 		0
0 		0
0 		0
0 		0
193,743 		0
0
(12) GEORGE C HALVORSON (i)
(ii)		 0
1,177,487 		0
5,155,125 		0
1,334,723 		0
62,481 		0
13,611 		0
7,743,427 		0
0
(13) SUSAN HENNESSY (i)
(ii)		 0
273,460 		0
166,537 		0
208,618 		0
281,667 		0
12,994 		0
943,276 		0
99,938
(14) JUDITH A JOHANSEN (i)
(ii)		 0
184,560 		0
0 		0
0 		0
0 		0
0 		0
184,560 		0
0
(15) MICHAEL KINARD (i)
(ii)		 233,490
0 		76,568
0 		4,745
0 		64,045
0 		12,994
0 		391,842
0 		0
0
(16) KATHRYN LANCASTER (i)
(ii)		 0
615,090 		0
919,900 		0
23,086 		0
283,406 		0
13,068 		0
1,854,550 		0
0
(17) CHRISTINE MALCOLM (i)
(ii)		 0
0 		0
0 		0
568,721 		0
0 		0
12,021 		0
580,742 		0
0
(18) PHILIP A MARINEAU (i)
(ii)		 0
193,623 		0
0 		0
0 		0
0 		0
0 		0
193,623 		0
0
(19) ANDREW R McCULLOCH (i)
(ii)		 0
392,037 		0
353,325 		0
67,791 		0
194,628 		0
12,994 		0
1,020,775 		0
0
(20) THOMAS R MEIER (i)
(ii)		 0
316,076 		0
297,094 		0
34,615 		0
94,371 		0
13,068 		0
755,224 		0
0
(21) JENNY J MING (i)
(ii)		 0
182,748 		0
0 		0
0 		0
0 		0
0 		0
182,748 		0
0
(22) SUSAN MULLANEY (i)
(ii)		 0
239,047 		0
86,475 		0
3,478 		0
15,497 		0
13,540 		0
358,037 		0
0
(23) DONALD ORNDOFF (i)
(ii)		 0
333,479 		0
0 		0
174,579 		0
57,212 		0
13,720 		0
578,990 		0
0
(24) EDWARD PEI (i)
(ii)		 0
168,250 		0
0 		0
0 		0
16,500 		0
0 		0
184,750 		0
0
(25) J NEAL PURCELL (i)
(ii)		 0
219,738 		0
0 		0
0 		0
0 		0
0 		0
219,738 		0
0
(26) KAREN SCHARTMAN (i)
(ii)		 0
271,324 		0
115,476 		0
15,795 		0
73,640 		0
13,068 		0
489,303 		0
0
(27) RICHIE SMITH (i)
(ii)		 0
251,555 		0
26,560 		0
23,222 		0
45,401 		0
13,203 		0
359,941 		0
0
(28) ARTHUR M SOUTHAM MD (i)
(ii)		 0
735,252 		0
1,241,861 		0
43,186 		0
342,622 		0
11,306 		0
2,374,227 		0
0
(29) DEBORAH STOKES (i)
(ii)		 0
313,713 		0
249,552 		0
59,377 		0
110,792 		0
13,068 		0
746,502 		0
40,338
(30) CYNTHIA A TELLES PHD (i)
(ii)		 0
182,647 		0
0 		0
0 		0
0 		0
0 		0
182,647 		0
0
(31) SANDRA P THOMPKINS (i)
(ii)		 0
166,951 		0
0 		0
0 		0
0 		0
0 		0
166,951 		0
0
(32) BERNARD J TYSON (i)
(ii)		 0
737,887 		0
1,180,500 		0
24,127 		0
346,893 		0
13,068 		0
2,302,475 		0
0
(33) WILLIAM N WIECHMANN (i)
(ii)		 0
225,300 		0
124,878 		0
15,709 		0
62,647 		0
12,994 		0
441,528 		0
0
(34) STEVEN ZATKIN (i)
(ii)		 0
283,028 		0
932,500 		0
31,725 		0
86,239 		0
11,477 		0
1,344,969 		0
0
(35) VICTORIA ZATKIN (i)
(ii)		 0
196,570 		0
80,174 		0
34,625 		0
81,763 		0
1,884 		0
395,016 		0
0
(36) MARK ZEMELMAN (i)
(ii)		 0
342,852 		0
224,105 		0
239,242 		0
137,956 		0
12,680 		0
956,835 		0
57,187
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
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 4a   Christine Malcolm $ 568,515 LISTED PERSONS PARTICIPATED IN ARRANGEMENTS ENTITLING THEM TO SEVERANCE BENEFITS IN THE EVENT OF TERMINATION BY THE ORGANIZATION WITHOUT CAUSE OR DUE TO JOB ELIMINATION. DEPENDING ON POSITION LEVEL, TENURE, AND TERMINATION REASON, SEVERANCE BENEFITS PAYABLE UNDER THESE ARRANGEMENTS PROVIDE FOR PAY AND HEALTH BENEFITS CONTINUATION PLUS PAYMENT OF ACCRUED OBLIGATIONS. IN ADDITION, FOR SOME OF THE LISTED PERSONS, SEVERANCE BENEFITS PAYABLE INCLUDE PRORATED INCENTIVE AWARDS FOR PERFORMANCE PERIODS NOT YET ENDED. NONE OF THE LISTED PERSONS PARTICIPATED IN ARRANGEMENTS ENTITLING THEM TO CHANGE-OF-CONTROL PAYMENTS.
Schedule J, Line 4b   George Halvorson $ 1,237,500 Mark Zemelman 218,741 Daniel Garcia 151,518 Susan Hennessy 99,938 Deborah Stokes 40,338 Steven Zatkin 5,463 Thomas Meier 609 Kathryn Lancaster 368 total $ 1,754,475 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.
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
KAISER FOUNDATION HEALTH PLAN
OF THE NORTHWEST
Employer identification number

93-0798039
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) MARK MALCOLM KFHP INC EMPLOYEE 96,476 COMPENSATION   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
KAISER FOUNDATION HEALTH PLAN
OF THE NORTHWEST
Employer identification number

93-0798039
Identifier Return Reference Explanation
Form 990, Part III, Lines 4a - 4d   2010 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 2010, the Northwest Health Plan served 476,345 medical members and another 181,673 dental members through 109 Permanente dentists and 8,346 full-time clinical, administrative and technical personnel. 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. Northwest Health Plan provides and arranges comprehensive health care services for members on a predominantly prepaid basis and fulfills its contractual obligations to group and individual members by contracting with KFH, and a Permanente Medical Group to provide required health care services. 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 2010, Northwest Health Plan expended $66 million for Community Benefit investments. 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 46 million Americans 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 2010, Health Plan in the Northwest spent $66 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 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 2010, the Northwest Health Plan spent $25 million on approximately 5,400 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 2010, Northwest Health Plan spent $8.9 million and served 7,726 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 $16.5 million to provide subsidized coverage to 5,400 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 - This 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 the financial criterion, and can not be enrolled in another private or pubic health care plan. Graduates are eligible for an additional six months coverage or until the employer-paid coverage is activated. - Child Health Plan - Northwest Health Plan offers full subsidy health insurance for eligible low-income students. Currently, 180 schools within the Multnomah Education Service District, Salem-Keizer School District and Hillsboro School District participate in this program. Students must be enrolled in a participating school, meet the financial criterion, and can not be enrolled in another private or pubic health care plan. The participating school districts act as the administrator for the program and are responsible for outreach and enrollment. - Washington Basic Health Plan - This program offers quality low-cost health coverage to eligible people who live in Washington State and managed by Washington Health Care Authority (HCA). The Northwest Health Plan provides services to eligible participants who reside in Clark or Cowlitz counties.
.   Participation in Medicaid and Other Government-Sponsored Programs The Northwest Health Plan provided coverage and services valued at $39 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. - Washington Basic Health Plus (BH-Plus) - This is Washington's Medicaid program for children under age of 19 who live in households that meet the eligibility guidelines for Medicaid. The Maternity Benefits Program is a Medicaid program for pregnant women. The Department of Social and Health Services (DSHS) determines eligibility for BH-Plus. Northwest Health Plan provides services to eligible participants who reside in Clark and Cowlitz counties. Medicaid to Nonmembers Northwest Health Plan contributed $1.2 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 high-risk insurance pools for the State of Oregon and Washington. 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. Assessments fund less than half of the program expenditures. The Oregon Medical Insurance Pool distributes the responsibility for paying the assessment among the health insurers based on the total number of Oregonians that each insures. The Northwest Health Plan contributed $16.2 million to these programs. 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 2010 the Northwest Health Plan provided human and in-kind support to more than 19 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 2010, Northwest Health Plan provided staff and in-kind support to more than 31 nonprofit safety net organizations in Oregon and Washington. OTHER COMMUNITY BENEFITS The Northwest Health Plan expended more than $119 thousand on community benefits activities and programs beyond the national streams of work. The following are examples: The Northwest Health Plan provided $60,000 in grant funding to the Dental Solutions for Children program that operates under the Salem Keizer School District. The program coordinates vital services to 64 schools by collaborating with multiple community partners, providing a safety net dental care program for low income, uninsured children in acute pain. Another Health Plan grant example is a $50,000 award to Chemeketa Community College Foundation. Chemeketa's Health Science Complex, opening in 2011, will include a community & teaching dental clinic that will provide low-cost or no-fee dental care to underserved populations. Students in Chemeketa's Dental Hygiene and Dental Assisting programs, under the supervision of a dentist, will provide care while receiving excellent hands-on experience.
.   2010 COMMUNITY BENEFIT INVESTMENT - NORTHWEST HEALTH PLAN The following chart summarizes 2010 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 and Coverage Programs $ 25,375,034 Government-Sponsored Programs 39,428,192 CB Operations for Care & Coverage 1,210,495 Subtotal: $ 66,013,721 COMMUNITY HEALTH INITIATIVES CB Operations for Community Health Initiatives $ 57,943 SAFETY NET PARTNERSHIPS Grants & Donations for Safety Net Partnerships $ 147,500 KNOWLEDGE DISSEMINATION CB Operations for Knowledge Dissemination $ 19,270 OTHER COMMUNITY BENEFITS Other CB Grants & Donations $ 118,560 TOTAL $ 66,356,994
Form 990, Part VI, Question 2   Family affiliations reported steven r zatkin - spouse: officer of kfhp inc., kfh and subsidiaries victoria zatkin - spouse: senior vp, general counsel and officer of kfh, kfhp inc. and regional health plans
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 THE REGIONAL 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 KPMG 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 $ (40,035,935) DISTRIBUTION TO PARENT (40,000,000) NET UNREALIZED GAIN ON INVESTMENT (6,332,067) Gain on sale of investments - book 9,470,437 Gain on sale of investments - tax (8,185,445) OTHER THAN TEMPORARY IMPAIRMENTS (1,877,849) TOTAL $ (86,960,858)
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:CHRISTINE K. CASSEL, MD TITLE:DIRECTOR HOURS:7
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:THOMAS W. CHAPMAN, EDD TITLE:DIRECTOR HOURS:8
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DANIEL P. GARCIA TITLE:SVP, Chief Compliance Officer HOURS:48
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:WILLIAM R. GRABER TITLE:DIRECTOR HOURS:7
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:J. EUGENE GRIGSBY, III, PHD TITLE:DIRECTOR HOURS:7
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:GEORGE C. HALVORSON TITLE:Chairman, CEO, President HOURS:45
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JUDITH A. 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 A. MARINEAU TITLE:DIRECTOR HOURS:6
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JENNY J. 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:J. NEAL PURCELL TITLE:DIRECTOR HOURS:9
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:CYNTHIA A. TELLES, PHD TITLE:DIRECTOR HOURS:7
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SANDRA P. THOMPKINS TITLE:DIRECTOR HOURS:6
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JENNIFER M. GARDNER TITLE:Special Asst to BOD HOURS:46
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:ANDREW R. McCULLOCH TITLE:REGIONAL PRESIDENT - NW HOURS:25
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:THOMAS R. MEIER TITLE:SVP & 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 M. SOUTHAM, MD TITLE:EVP - HEALTH PLAN OPERATIONS HOURS:45
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DEBORAH STOKES TITLE:SVP, CORPORATE CONTROLLER, CAO HOURS:46
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:BERNARD J. TYSON TITLE:President & COO HOURS:45
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:WILLIAM N. WIECHMANN TITLE:VP, REGIONAL COUNSEL - NW HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:STEVEN ZATKIN TITLE:SVP, General Counsel & Secreta HOURS:45
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, General Counsel & Secreta HOURS:46
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 HEALTH PLAN SERVICES HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SUSAN MULLANEY TITLE:HOSPITAL ADMINISTRATOR HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KAREN SCHARTMAN TITLE:VP & CFO - NW HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MARK BURMESTER TITLE:VP STRATEGIC PLANNING & COMM 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:MICHAEL THOMAS GRANT TITLE:VP HEALTH PLAN SERVICES ADMIN 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:CHRISTINE MALCOLM TITLE:FORMER SVP HOURS:
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
KAISER FOUNDATION HEALTH PLAN
OF THE NORTHWEST
Employer identification number

93-0798039
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity







(1) Kaiser Permanente Oregon Plus LLC
ONE KAISER PLAZA 15L
OAKLAND,CA94612
20-2396517 		HEALTH CARE OR 17,564,069 752,963 na
 










Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) Kaiser Foundation Health Plan Inc

ONE KAISER PLAZA 15L

OAKLAND,CA94612
94-1340523 		HEALTH CARE CA 501(C)(3) 9 NA
 
 
 
(2) Kaiser Foundation Health Plan of CO Inc

ONE KAISER PLAZA 15L

OAKLAND,CA94612
84-0591617 		HEALTH CARE CO 501(C)(3) 9 KFHP INC
 
 
 
(3) Kaiser Foundation Health Plan of GA Inc

ONE KAISER PLAZA 15L

OAKLAND,CA94612
58-1592076 		HEALTH CARE GA 501(C)(3) 9 KFHP INC
 
 
 
(4) Kaiser Foundation Health Plan of the MAS

ONE KAISER PLAZA 15L

OAKLAND,CA94612
52-0954463 		HEALTH CARE MD 501(C)(3) 9 KFHP INC
 
 
 
(5) Kaiser Foundation Health Plan of OH Inc

ONE KAISER PLAZA 15L

OAKLAND,CA94612
34-0922268 		HEALTH CARE OH 501(C)(3) 9 KFHP INC
 
 
 
(6) Kaiser Foundation Hospitals

ONE KAISER PLAZA 15L

OAKLAND,CA94612
94-1105628 		HEALTH CARE CA 501(C)(3) 3 KFHP INC
 
 
 
(7) Camp Bowie Service Center

ONE KAISER PLAZA 15L

OAKLAND,CA94612
94-3299123 		ADMIN CA 501(C)(3) 11 KFHP INC
 
 
 
(8) Kaiser Health Alternatives

ONE KAISER PLAZA 15L

OAKLAND,CA94612
93-0954562 		HEALTH CARE OR 501(C)(3) 9 KFHP INC
 
 
 
(9) Kaiser Hospital Asset Management Inc

ONE KAISER PLAZA 15L

OAKLAND,CA94612
94-3299125 		ASSET MGMT CA 501(C)(3) 11 KFH
 
 
 
(10) Kaiser Health Plan Asset Management Inc

ONE KAISER PLAZA 15L

OAKLAND,CA94612
94-3299124 		ASSET MGMT CA 501(C)(3) 11 KFHP INC
 
 
 
(11) Lokahi Assurance Ltd

ONE KAISER PLAZA 15L

OAKLAND,CA94612
91-2171891 		risk mgmt HI 501(C)(3) 11 KFHP INC
 
 
 
(12) OHP

ONE KAISER PLAZA 15L

OAKLAND,CA94612
93-0480268 		LEASING WA 501(C)(3) 11 KFHP INC
 
 
 
(13) 1800 Harrison Foundation

ONE KAISER PLAZA 15L

OAKLAND,CA94612
94-3317484 		FINANCING CA 501(C)(3) 11 KFHP INC
 
 
 
(14) KAISER HOSPITAL ASSISTANCE CORPORATION

ONE KAISER PLAZA 15L

OAKLAND,CA94612
31-1779500 		FINANCING CA 501(C)(3) 11 KFH
 
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) Health Care Management Solutions LLC

ONE KAISER PLAZA 15L
OAKLAND,CA94607
20-3924985 		CONSULTING CA NA
  		NONE 0 0   No 0   No 0 %












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) Archimedes Inc
ONE KAISER PLAZA 15L
OAKLAND,CA94612
20-3774729 		CONSULTING CA NA
  		C CORP 0 0 0 %
(2) Kaiser Permanente International
ONE KAISER PLAZA 15L
OAKLAND,CA94612
94-3245176 		CONSULTING CA NA
  		C CORP 0 0 0 %
(3) Kaiser Permanente Insurance Company
ONE KAISER PLAZA 15L
OAKLAND,CA94612
94-3203402 		INSURANCE CA NA
  		C CORP 0 0 0 %
(4) Kaiser Properties Services Inc
ONE KAISER PLAZA 15L
OAKLAND,CA94612
94-3259432 		REAL ESTATE CA NA
  		C CORP 0 0 0 %
(5) Oak Tree Assurance Ltd
ONE KAISER PLAZA 15L
OAKLAND,CA94612
03-0329760 		INSURANCE VT NA
  		C CORP 0 0 0 %




Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
Yes
 
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
Yes
 
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) KAISER FOUNDATION HOSPITALS

 D 2,212,212,095  
(2) KAISER FOUNDATION HOSPITALS

 E 1,309,297,671  
(3) KAISER FOUNDATION HOSPITALS

 H 4,107,224  
(4) KAISER FOUNDATION HEALTH PLAN INC

 K 6,624,163  
(5) KAISER FOUNDATION HEALTH PLAN OF COLORADO

 K 192,711  
(6) KAISER FOUNDATION HEALTH PLAN OF GEORGIA

 K 7,173  
(7) KAISER FOUNDATION HEALTH PLAN OF THE MAS

 K 3,586  
(8) KAISER FOUNDATION HEALTH PLAN OF OHIO

 K 4,430  
(9) KAISER PERMANENTE INSURANCE COMPANY

 K 842,798  
(10) KAISER FOUNDATION HEALTH PLAN INC

 L 60,215,183  
(11) KAISER FOUNDATION HOSPITALS

 L 621,769,177  
(12) KAISER FOUNDATION HEALTH PLAN OF COLORADO

 L 242,078  
(13) KAISER FOUNDATION HEALTH PLAN OF GEORGIA

 L 118,598  
(14) KAISER FOUNDATION HEALTH PLAN OF THE MAS

 L 212,197  
(15) KAISER FOUNDATION HEALTH PLAN of OHIO

 L 29,179  
(16) CAMP BOWIE SERVICE CENTER

 L 8,057,222  
(17) LOKAHI ASSURANCE LTD

 L 24,657,882  
(18) KAISER FOUNDATION HEALTH PLAN INC

 N 5,084  
(19) KAISER FOUNDATION HEALTH PLAN INC

 O 22,950,243  
(20) KAISER FOUNDATION HOSPITALS

 O 486,683,237  
(21) KAISER FOUNDATION HEALTH PLAN OF COLORADO

 O 228,106  
(22) KAISER FOUNDATION HEALTH PLAN OF GEORGIA

 O 4,774  
(23) KAISER FOUNDATION HEALTH PLAN OF THE MAS

 O 15,038  
(24) KAISER FOUNDATION HEALTH PLAN OF OHIO

 O 472  
(25) CAMP BOWIE SERVICE CENTER

 O 237,086  
(26) KAISER FOUNDATION HEALTH PLAN INC

 P 12,307,267  
(27) KAISER FOUNDATION HOSPITALS

 P 570,882,845  
(28) KAISER FOUNDATION HEALTH PLAN OF COLORADO

 P 2,296,139  
(29) KAISER FOUNDATION HEALTH PLAN OF GEORGIA

 P 1,162  
(30) KAISER FOUNDATION HEALTH PLAN OF THE MAS

 P 6,233  
(31) KAISER FOUNDATION HEALTH PLAN OF OHIO

 P 1,675  
(32) LOKAHI ASSURANCE LTD

 P 3,782,163  
(33) KAISER FOUNDATION HEALTH PLAN INC

 Q 40,002,199  
(34) KAISER FOUNDATION HOSPITALS

 Q 402,977,828  
(35) KAISER FOUNDATION HEALTH PLAN INC

 R 14,195  
(36) KAISER FOUNDATION HOSPITALS

 R 369,689,347  
(37) KAISER FOUNDATION HOSPITALS

 R 184,928,003  
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


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