TY 2011 Form 990

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) Peter Andruszkiewicz Region President - Georgia	30.0	X	X		0	634,729	138,008
(2) Kerry Kohnen Region President - Georgia	40.0	X	X		0	695,379	141,557
(3) Jeffrey Koplan Director	1.0	X			12,000	0	0
(4) Donna Lynne Director	4.0	X	X		0	1,314,917	222,947
(5) J Neal Purcell Director	1.0	X			13,000	221,858	0
(6) Bernard Tyson Director & Chair	5.0	X	X		0	2,800,296	482,152
(7) George Halvorson Chairman and CEO	5.0		X		0	7,861,915	74,595
(8) Kathryn Lancaster EVP & CFO	4.0		X		0	2,109,102	289,626
(9) Kirkland McGhee VP, Regional Counsel - GA	50.0		X		0	218,783	38,441
(10) Thomas Meier SVP, Corporate Treasurer	3.0		X		0	802,247	110,802
(11) Donald Orndoff SVP, NFS	5.0		X		0	634,274	137,999
(12) Arthur Southam EVP, Health Plan Operations	5.0		X		0	2,649,224	348,687
(13) Deborah Stokes SVP, CC & CAO	4.0		X		0	720,302	118,018
(14) Victoria Zatkin Assistant Secretary	4.0		X		0	314,768	84,531
(15) Mark Zemelman SVP, Gen Counsel & Secretary	3.0		X		0	778,576	191,923
(16) James Cullinan VP, Mktg Sales & Bus Dev't	30.0			X	0	278,833	65,822
(17) Carrie J Jennison VP, CFO - Georgia	30.0			X	0	617,276	83,687

(A) Name and business address	(B) Description of services	(C) Compensation
PIEDMONT HOSPITAL PO BOX 102526 ATLANTA,GA30368	MEDICAL SERVICES	59,057,983
NORTHSIDE HOSPITAL PO BOX 101818 ATLANTA,GA30392	MEDICAL SERVICES	73,777,759
SOUTHEASTERN PERMANENTE MEDICAL GRO 3495 PIEDMONT ROAD NE ATLANTA,GA30305	MEDICAL SERVICES	365,807,869
CHILDREN'S HEALTHCARE OF ATLANTA PO BOX 116101 ATLANTA,GA30368	MEDICAL SERVICES	14,224,131
BRASFIELD GORRIE LLC 1990 VAUGHN ROAD 100 KENNESAW,GA30144	GENERAL CONTRACTING	12,597,815
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 358

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 United States. See Part IV, line 21	12,022,634	12,022,634
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. 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 ....	25,000		25,000
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	137,262,384	117,939,558	19,322,826	0
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	12,696,811	12,696,811
9	Other employee benefits .......	22,111,762	16,621,965	5,489,797
10	Payroll taxes ...........	10,025,922	10,025,922
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	2,540		2,540
c	Accounting ...........	952,768		952,768
d	Lobbying ...........	165,687		165,687
e	Professional fundraising. See Part IV, line 17..	0
f	Investment management fees ......	0
g	Other ..........	83,805,409	66,974,139	16,831,270
12	Advertising and promotion ....	20,912,348	13,251,580	7,660,768
13	Office expenses .......	2,325,918	2,066,973	258,945
14	Information technology ......	68,526,935	57,935,135	10,591,800
15	Royalties ..	0
16	Occupancy ...........	11,298,814	11,298,814
17	Travel ............	1,546,156	1,161,992	384,164
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	519,278		519,278
20	Interest ...........	10,958,793	10,958,793
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	15,022,540	15,022,540
23	Insurance ..............	1,772,669	1,772,669
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a	PURCHASED MEDICAL SVC - BCP	543,339,983	543,339,983
b	SUPPLIES	117,070,088	106,373,263	10,696,825
c	INTER-REGIONAL CHARGES	30,690,865	25,959,923	4,730,942
d	REPAIRS & MAINTENANCE	8,876,033	8,804,913	71,120
e
f	All other expenses	17,615,477	5,790,968	11,824,509
25	Total functional expenses. Add lines 1 through 24f	1,129,546,814	1,040,018,575	89,528,239	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........	406,177	1	695,806
2	Savings and temporary cash investments .......	0	2	0
3	Pledges and grants receivable, net .........	0	3	0
4	Accounts receivable, net .........	26,718,979	4	32,310,378
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........	0	5	0
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 ..........	0	6	0
7	Notes and loans receivable, net .............	0	7	0
8	Inventories for sale or use ..............	9,806,294	8	10,527,838
9	Prepaid expenses and deferred charges ............	867,207	9	1,280,557
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	331,584,283
b	Less: accumulated depreciation. .....	10b	145,360,539	140,809,725	10c	186,223,744
11	Investments—publicly traded securities ..........	193,511,986	11	144,304,913
12	Investments—other securities. See Part IV, line 11 ......	0	12	0
13	Investments—program-related. See Part IV, line 11 ..	0	13	0
14	Intangible assets .........	0	14	0
15	Other assets. See Part IV, line 11 ...........	363,626	15	460,809
16	Total assets. Add lines 1 through 15 (must equal line 34)...	372,483,994	16	375,804,045
	17	Accounts payable and accrued expenses .	84,150,555	17	97,667,730
18	Grants payable ..........	0	18	0
19	Deferred revenue ..........	9,470,758	19	16,107,012
20	Tax-exempt bond liabilities ..........	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	0	21	0
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ....	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.....	326,754,971	25	354,274,017
26	Total liabilities. Add lines 17 through 25.....	420,376,284	26	468,048,759
		Organizations that follow SFAS 117, check here 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 and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....	5,665,218	30	5,665,218
31	Paid-in or capital surplus, or land, building or equipment fund .....	0	31	0
32	Retained earnings, endowment, accumulated income, or other funds	-53,557,508	32	-97,909,932
33	Total net assets or fund balances .....	-47,892,290	33	-92,244,714
34	Total liabilities and net assets/fund balances .....	372,483,994	34	375,804,045

- TIN:

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.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization

KAISER FDN HEALTH PLAN OF GEORGIAINC

Employer identification number

58-1592076

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.)

A church, convention of churches, or association of churches. section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

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.)

An organization organized and operated exclusively to test for public safety. Seesection 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

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)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(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?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2011

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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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).

Gross receipts from related activities, etc. (See instructions.) ..................

First Five Years If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.......................................... right arrow

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2011. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2010. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2011. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions ................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2011

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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .	1,562,162	1,882,337	2,057,241	2,350,668	8,056,693	15,909,101
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......	1,041,404,677	1,083,297,320	1,060,150,602	945,171,878	1,087,593,114	5,217,617,591
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.	1,042,966,839	1,085,179,657	1,062,207,843	947,522,546	1,095,649,807	5,233,526,692
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.)						5,233,526,692

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(f) Total
9	Amounts from line 6...	1,042,966,839	1,085,179,657	1,062,207,843	947,522,546	1,095,649,807	5,233,526,692
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..	7,749,684	6,513,719	5,254,905	4,327,774	3,549,083	27,395,165
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.	7,749,684	6,513,719	5,254,905	4,327,774	3,549,083	27,395,165
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.).	1,050,716,523	1,091,693,376	1,067,462,748	951,850,320	1,099,198,890	5,260,921,857

Section C. Computation of Public Support Percentage

Public Support Percentage for 2011 (line 8 column (f) divided by line 13 column (f)) .........

99.479 %

Public support percentage from 2010 Schedule A, Part III, line 15 ...............

99.396 %

Section D. Computation of Investment Income Percentage

Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f)) ......

0.521 %

Investment income percentage from 2010 Schedule A, Part III, line 17 .............

0.604 %

19a

33 1/3% support tests—2011. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2010. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2011

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

Schedule A (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2011

Name of organization

KAISER FDN HEALTH PLAN OF GEORGIAINC

Employer identification number

58-1592076

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not total to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year. ......................... 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 on line H of its
Form 990-EZ or on Part I, 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) (2011)

Page 2

Name of organization KAISER FDN HEALTH PLAN OF GEORGIAINC
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Part I	Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3

Name of organization KAISER FDN HEALTH PLAN OF GEORGIAINC
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Part II	Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
(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) (2011)

Page 4

Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Name of organization
KAISER FDN HEALTH PLAN OF GEORGIAINC

Employer identification number

58-1592076

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total 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

$
Use duplicate copies of Part III if additional space is needed

(a) No.
from
Part I

(b)
Purpose 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

(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

(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

(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) (2011)

Additional Data

Software ID:
Software Version:

- TIN:

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

2011

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, line 35c (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

KAISER FDN HEALTH PLAN OF GEORGIAINC

Employer identification number

58-1592076

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c) except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

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) 2011

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 if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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? ......................................	Yes No

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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) Total

2a	Lobbying non-taxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2011

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)).

For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

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:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Yes

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Yes

Publications, or published or broadcast statements? .......................

Yes

Grants to other organizations for lobbying purposes? .......................

Yes

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Yes

156,312

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? ..........................

Yes

9,375

Total. Add lines 1c through 1i ...............................

165,687

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

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

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2 are answered “No” OR (b) Part III-A, line 3 is answered “Yes”.

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ...........................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

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, Part II-A; line 5; and Part ll-B, line 1.
Also, complete this part for any additional information.

Identifier	Return Reference	Explanation
SCHEDULE C, PART II-B, LINE 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: - 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. - 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. - 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. - 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) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

KAISER FDN HEALTH PLAN OF GEORGIAINC

Employer identification number

58-1592076

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 .......

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? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can 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? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax 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, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

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)? ....................................

Yes No

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.

If the organization elected, as permitted under SFAS 116 (ASC 958), 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.

If the organization elected, as permitted under SFAS 116 (ASC 958), 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

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 (ASC 958), relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2011

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.

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?........

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIV and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

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	Net investment earnings, gains, and losses ...
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the year end balance (line 1g) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIV the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	24,371,491		24,371,491
b	Buildings ................	125,305,855	59,390,835	65,915,020
c	Leasehold improvements ............	34,127,275	18,101,660	16,025,615
d	Equipment ................	94,025,417	62,897,389	31,128,028
e	Other .................	53,754,245	4,970,655	48,783,590
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				186,223,744

Schedule D (Form 990) 2011

Page 3

Part VII

InvestmentsOther 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) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram 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) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of Liability		(b) Book value
Federal Income Taxes		0
PENSION PLAN PAYABLE		63,786,210
SELF INS RISK-PROF PUBLIC LIAB		34,125,900
OTHER CURRENT LIABILITIES		6,655,981
OTHER LONG-TERM LIABILITIES		7,979,590
DUE TO AFFILIATED ORGANIZATION		56,957,689
PREMIUM DEFICIENCY RESERVE		18,998,480
NOTE PAYABLE TO AFFILIATES		164,330,167
SELF INS RISK - WORKERS COMP		1,440,000

Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		354,274,017
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) 2011

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	1,099,886,179
2	Total expenses (Form 990, Part IX, column (A), line 25) .....................	2	1,129,546,814
3	Excess or (deficit) for the year. Subtract line 2 from line 1 .............	3	-29,660,635
4	Net unrealized gains (losses) on investments ..........................	4	-542,029
5	Donated services and use of facilities .............................	5
6	Investment expenses ...................................	6
7	Prior period adjustments ..................................	7
8	Other (Describe in Part XIV.) .................................	8	-14,149,760
9	Total adjustments (net). Add lines 4 through 8 .........................	9	-14,691,789
10	Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 .........	10	-44,352,424

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	1,082,662,332
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a	-542,029
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIV.) ............	2d	5,943,538
e	Add lines 2a through 2d .....................			2e	5,401,509
3	Subtract line 2e from line 1.....................			3	1,077,260,823
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	22,625,356
c	Add lines 4a and 4b.......................			4c	22,625,356
5	Total Revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	1,099,886,179

Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements .............			1	1,127,014,756
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
d	Other (Describe in Part XIV.) ............	2d	-2,532,058
e	Add lines 2a through 2d......................			2e	-2,532,058
3	Subtract line 2e from line 1.....................			3	1,129,546,814
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
c	Add lines 4a and 4b.......................			4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	1,129,546,814

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 X, LINE 2	FIN 48 FOOTNOTE	NOT REQUIRED
SCHEDULE D, PART XI, LINE 8	RECONCILIATION OF CHANGE IN NET ASSETS	DECREASE IN PENSION & OTHER COMPREHENSIVE INCOME <$13,935,473> GAIN/LOSS ON INVESTMENTS - TAX < 679,945> GAIN/LOSS ON INVESTMENTS - BOOK 959,929 SEE "NOTE 1" < 494,271> ____________ TOTAL <$14,149,760> 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	RECONCILIATION OF REVENUE	LINE 2D: INTER-ENTITY REVENUE - RECLASS 5,477,880 GAIN/LOSS ON INVESTMENTS - BOOK 959,929 OTTI < 494,271> _____________ TOTAL $5,943,538 LINE 4B: FIXED ASSET LOSS - RECLASS <$ 980> PREMIUM DEFICIENCY RESERVES - RECLASS 21,946,391 GAIN/LOSS ON INVESTMENTS - TAX 679,945 ___________ TOTAL $22,625,356
SCHEDULE D, PART XIII	RECONCILIATION OF EXPENSES	LINE 2D: FIXED ASSET LOSS - RECLASS $ 980 INTER-ENTITY REVENUE - RECLASS 5,477,880 DECREASE IN PENSION & OTHER COMPREHENSIVE INCOME 13,935,473 PREMIUM DEFICIENCY RESERVES - RECLASS <21,946,391> _____________ TOTAL <$ 2,532,058>

Schedule D (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

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

2011

Open to Public
Inspection

Name of the organization
KAISER FDN HEALTH PLAN OF GEORGIAINC

Employer identification number
58-1592076

Part I

General Information on Grants and Assistance

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? ....................................

Yes No

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	(h) Purpose of grant or assistance
(1) AID Gwinnett Inc3075 Breckinridge Blvd415 Duluth,GA30096	58-1973324	501(c)(3)	75,000	High-Risk Youth HIV
(2) American Heart Association Inc1101 Northchase Pkwy 1 Marietta,GA30067	13-5613797	501(c)(3)	92,880	Children's Nutrition
(3) Angel Flight of Georgia Inc2000 Airport Rd 227 Atlanta,GA30341	58-1702239	501(c)(3)	37,344	Fly A Metro Atlantan
(4) Armstrong Atlantic State Univ Fdn Inc11935 Abercorn St Savannah,GA31419	58-1577237	501(c)(3)	25,000	Nursing Recruitment
(5) Arthritis Foundation SE Region Inc2970 Peachtree Rd NW 200 Atlanta,GA30305	38-3806275	501(c)(3)	30,000	Life Improvement
(6) Assoc of State &Territorial Chronic Disease2872 Woodstock Blvd 220 Atlanta,GA30341	73-1328414	501(c)(3)	99,864	School Network Proj
(7) Athens Area Community Fdn Inc1240 S Lumpkin St Athens,GA30602	26-1838979	501(c)(3)	25,000	Athens Health Netwrk
(8) Atlanta Bicycle Coalition213 Mitchell St Atlanta,GA30303	58-1996013	501(c)(3)	10,000	Bicycle Educ Prog
(9) Atlanta Community Food Bank Inc732 Joseph E Lowery Blvd NW Atlanta,GA30318	58-1376648	501(c)(3)	75,000	Nutrition Education
(10) Atlanta Leadership Development Fdn IncTen Peachtree Place 620 Atlanta,GA30309	23-7015688	501(c)(3)	6,000	Health Day 2011
(11) Atlanta Regional Commission40 Courtland St NE Atlanta,GA30303	58-6002324	501(c)(3)	68,000	Sr Community Garden
(12) Atlanta Women's Fdn Inc50 Hurt Plaza 401 Atlanta,GA30303	58-2389721	501(c)(3)	125,000	Women's Foundation
(13) Atlanta BeltLine Partnership Inc50 Hurt Plaza 910 Atlanta,GA30303	56-2464486	501(c)(3)	1,250,000	Beltline Project
(14) Boys and Girls Clubs of Metro Atlanta Inc100 Edgewood Ave NE 700 Atlanta,GA30303	58-0566123	501(c)(3)	75,000	Teen Ambassadors
(15) Brain Tumor Fdn for Children Inc6065 Roswell Rd NE 505 Atlanta,GA30328	58-1524616	501(c)(3)	30,000	Butterfly Fund Hosp
(16) Camp Kudzu Inc5885 Glenridge Dr 160 Atlanta,GA30328	58-2449646	501(c)(3)	25,000	Diabetes Management
(17) Camp Twin Lakes Inc600 Means St 110 Atlanta,GA30318	58-1826782	501(c)(3)	22,100	Sustainable EducFarm
(18) Center for Pan Asian Community Svcs Inc3510 Shallowford Rd NE Atlanta,GA30341	58-1437980	501(c)(3)	72,810	Dowa Clinic
(19) Chattahoochee Nature Center Inc9135 Willeo Rd Roswell,GA30075	58-1275604	501(c)(3)	32,553	Community Garden
(20) Children's Healthcare of Atlanta Inc1584 Tullie Circle NE Atlanta,GA30329	58-1710601	501(c)(3)	1,000,000	Children Healthcare
(21) CHRIS Kids Inc3109 Clairmont Rd B Atlanta,GA30329	58-1430183	501(c)(3)	50,000	Trauma Treatment
(22) Clarkston Community Center Fdn Inc3701 College Ave Clarkston,GA30021	58-2127610	501(c)(3)	20,000	Food Security/Active
(23) Clayton County Board of Health1117 Battlecreek Rd Jonesboro,GA30236	58-1108112	Government	75,000	Hyperten & Diabetes
(24) Clayton State University Fdn Inc2000 Clayton State Blvd Morrow,GA30260	23-7419285	501(c)(3)	85,000	Nursing Recruitment
(25) Cobb County Board of Health1650 County Srvcs Pkwy Marietta,GA30008	58-1517015	Government	75,000	Babies Born Healthy
(26) Cobb County Community Services Board3830 S Cobb Dr 300 Suite 200 Smyrna,GA30080	58-2107033	Government	75,000	Project Gateway
(27) Community Advanced Practice Nurses Inc173 Boulevard NE Atlanta,GA30312	58-2435328	501(c)(3)	74,847	Healthcare/Med Home
(28) DeKalb Community Service Board445 Winn Way 4th Fl Decatur,GA30031	58-2104166	Government	74,029	Telehealth
(29) DeKalb County Board of Health445 Winn Way Decatur,GA30031	58-1417092	Government	75,000	Expansion HIV Prg
(30) DeKalb Habitat for Humanity2915 Midway Rd Decatur,GA30030	58-1792761	501(c)(3)	90,000	A Brush w/ Kindness
(31) Diabetes Association of Atlanta Inc100 Edgewood Ave NE 1004 Atlanta,GA30303	58-0973055	501(c)(3)	65,000	Diabetes Prevention
(32) Families First Inc1105 W Peachtree St NE Atlanta,GA30357	58-1054331	501(c)(3)	84,250	Healthy Babies/Moms
(33) Fayette Care Clinic Inc1260 Highway 54W101 Fayetteville,GA30214	20-0314897	501(c)(3)	85,000	FCC Community Wellns
(34) Fernbank Inc767 Clifton Rd Atlanta,GA30307	58-6028607	501(c)(3)	50,000	Fernbank Youth Educ
(35) First Step Staffing236 Auburn Ave NE 203 Atlanta,GA30303	20-8038859	501(c)(3)	65,000	First Step Staffing
(36) Four Corners Primary Care Centers Inc5030 Georgia Belle Court Norcross,GA30093	20-5870972	501(c)(3)	74,963	Keep in Touch Prog
(37) Georgia Campaign AdolescPregn Prevent Inc1450 W Peachtree St NW 200 Atlanta,GA30309	31-1520709	501(c)(3)	46,719	Be Proud/Respons
(38) Georgia Conservancy Inc817 W Peachtree St 200 Atlanta,GA30308	58-1027246	501(c)(3)	52,350	Dev & Training
(39) Georgia Family Connection Partnership Inc235 Peachtree St 1600 Atlanta,GA30303	58-1888262	501(c)(3)	75,000	Reducing Low Birthwt
(40) Georgia Free Clinic Network Inc1015 Donald Lee Hollowell Pkwy 20 Atlanta,GA30318	80-0100336	501(c)(3)	49,425	GFCN Operating Suprt
(41) Georgia Health News Inc2635 Rangewood Court Atlanta,GA30345	27-3543332	501(c)(3)	8,500	HealthCare SafetyNet
(42) Georgia Lions Lighthouse Fdn Inc5582 Peachtree Rd Suite 290 Chamblee,GA30341	58-0548732	501(c)(3)	50,000	Access Vision Care
(43) Georgia Organics Inc200 A Ottley Dr Atlanta,GA30324	58-2345310	501(c)(3)	75,000	GA Organics Iniative
(44) Georgia Perimeter College Fdn Inc3251 Panthersville Rd Decatur,GA30034	58-1492364	501(c)(3)	85,000	Nursing Recruitment
(45) Georgia Southern University Fdn Inc2472 Akins Blvd Statesboro,GA30460	58-6034031	501(c)(3)	25,000	Nursing Recruitment
(46) Georgia State University Fdn IncOne Park Place 533 Atlanta,GA30303	58-6033185	501(c)(3)	92,500	Nursing Recruitment
(47) Girl Scout Council of Northwest GA Inc5601 N Allen Rd Mableton,GA30126	58-0566190	501(c)(3)	25,000	Summer Ed & Wellness
(48) Good News Clinics Inc810 Pine St Gainesville,GA30501	58-2058853	501(c)(3)	75,000	Promoting Wellness
(49) Good Samaritan Health & Wellness Ctr Inc175 Samaritan Way Jasper,GA30143	58-2576315	501(c)(3)	63,750	Community Needs Proj
(50) Good Samaritan Health Center of Cobb Inc1605 Roberta Dr SW Marietta,GA30008	32-0045238	501(c)(3)	75,000	Primary Medical
(51) Good Samaritan Health Center Inc1015 Donald Lee Hollowell Pkwy Atlanta,GA30318	58-2373395	501(c)(3)	75,000	Patient Navigation
(52) Grant Park Family Health Center Inc1340 Boulevard SE Atlanta,GA30315	58-1577640	501(c)(3)	69,474	Hispanic Diabetes
(53) Gwinnett Community Clinic Inc2160 Fountain Dr Snellville,GA30078	58-1868227	501(c)(3)	22,500	Primary Care
(54) HABESHA Inc477 Windsor St Atlanta,GA30312	02-0536428	501(c)(3)	10,750	Urban Agriculture
(55) Hands of Hope Clinic Inc1010 Hospital Dr B Stockbridge,GA30281	42-1591970	501(c)(3)	37,750	Diabetic Self-Care
(56) Health Educ Assessment & Leadership Inc1300 Joseph E Boone Blvd NW Atlanta,GA30314	26-3990559	501(c)(3)	33,357	HEALing Community
(57) Heritage Fund of Atlanta Medical Assoc Inc100 Edgewood Ave NE 975 Atlanta,GA30303	58-2372394	501(c)(3)	9,100	Heritage Fund
(58) Hispanic Health Coalition of Georgia Inc424 Decatur St Atlanta,GA30312	75-2995466	501(c)(3)	37,060	Prenatal Care
(59) Hope Health Clinic Inc125 N 10th St Griffin,GA30223	20-0719396	501(c)(3)	75,000	Dietary Effect
(60) Jerusalem House Inc17 Executive Pk Dr NE290 Atlanta,GA30329	58-1829807	501(c)(3)	50,000	Housing Programs
(61) Junior Achievement of Georgia Inc460 Abernathy Rd Atlanta,GA30328	58-0598050	501(c)(3)	35,000	Program Support
(62) Keep Cobb Beautiful Inc1940 County Srvcs Pkwy Marietta,GA30008	58-1659192	501(c)(3)	9,800	Medication Disposal
(63) Kennesaw State University Fdn Inc1000 Chastain Rd Kennesaw,GA30066	23-7034345	501(c)(3)	99,915	Nursing Recruitment
(64) Macon College Fdn Inc100 College Station DrA217 Macon,GA31210	23-7066010	501(c)(3)	25,000	Nursing Endowment
(65) Martin Luther King Jr Ctr Nonviolent Social449 Auburn Ave NE Atlanta,GA30312	58-1030989	501(c)(3)	13,500	Awards Dinner
(66) Martin Luther King Jr Poor Peoples Church1035 Donnelly Ave SW Atlanta,GA30310	58-1340903	501(c)(3)	50,000	Community Outrch Prg
(67) McIntosh Trail Community Service Board1501-A Kalamazoo Dr Suite 100 Griffin,GA30224	58-2098758	Government	74,859	Spalding Health
(68) Ministries United for Service & Training1407 Cobb Pkwy N Marietta,GA30061	58-2034725	501(c)(3)	58,140	Summer Lunch
(69) Morehouse College830 Westview Dr NW Atlanta,GA30314	58-0566205	501(c)(3)	25,000	Scholarship Fund
(70) National Mental Health Assoc of GA Inc100 Edgewood Ave 502 Atlanta,GA30303	58-0611310	501(c)(3)	56,000	Access and Treatment
(71) New Hope Initiatives Inc970 Jefferson St Atlanta,GA30318	27-0230104	501(c)(3)	40,000	Job Readiness
(72) North Fulton Community Charities Inc11270 Elkins Rd Roswell,GA30076	58-1521088	501(c)(3)	25,000	Emergency Financial
(73) Oakhurst Community Garden Project Inc435 Oakview Rd Decatur,GA30030	58-2339007	501(c)(3)	20,000	Youth Outreach
(74) Our House Inc711 Columbia Dr Suite 300 Decatur,GA30030	58-1743333	501(c)(3)	15,000	Family Advocacy
(75) Palmetto Health Council Inc547 Ponce de Leon Ave200 Atlanta,GA30308	58-1307597	501(c)(3)	75,000	Case Mgmt Project
(76) Park Pride Atlanta Inc233 Peachtree St NE 1600 Atlanta,GA30303	58-1883895	501(c)(3)	33,550	Community Gardens
(77) Partnership Against Domestic Violence114 New St L Decatur,GA30030	58-1314556	501(c)(3)	50,000	Violence Prevention
(78) Pedestrians Educating Drivers Safety1389 Peachtree St NE 202 Atlanta,GA30309	58-2267503	501(c)(3)	25,000	Safe Routes Transit
(79) Piedmont Park Conservancy Inc400 Park Dr NE Atlanta,GA30306	58-1551369	501(c)(3)	345,000	Healthy Living
(80) Project Open Hand-Atlanta Inc176 Ottley Dr Atlatnta,GA30324	58-1816778	501(c)(3)	65,000	Market Basket Pantry
(81) Rally Fdn Inc5775 Glenridge Dr Bldg B 370 Atlanta,GA30328	20-1950849	501(c)(3)	7,500	Public Policy
(82) Robert W Woodruff Arts Center Inc1280 Peachtree St NE Atlanta,GA30309	58-0633971	501(c)(3)	99,000	Corporate Campaign
(83) Rockdale Coalition Chidlren & Families2796 Georgia Highway 20 S Conyers,GA30013	58-2336561	501(c)(3)	10,000	Mercy Heart Clinic
(84) Senior Citizen Svcs Metropolitan Atlanta1705 Commerce Dr NW Atlanta,GA30318	58-0960309	501(c)(3)	49,125	Extra Helping
(85) Senior Connections Inc5328 Peachtree Rd Chamblee,GA30341	58-1187876	501(c)(3)	50,000	Meals On Wheels Svcs
(86) Senior Services North Fulton Inc490 Sun Valley Dr 202 Roswell,GA30076	58-1948370	501(c)(3)	25,000	Seniors (TOPS)
(87) Special Olympics Georgia Inc4000 DeKalb Technology Pkwy 400 B Atlanta,GA30340	23-7201676	501(c)(3)	7,500	Health and Wellness
(88) Susan G Komen Breast Cancer Fdn4840 Roswell Rd Bldg D 100 Atlanta,GA30342	58-1959763	501(c)(3)	25,000	Komen Race for Cure
(89) The Center Black Women's Wellness CBWW477 Windsor St SW 309 Atlanta,GA30312	58-2212203	501(c)(3)	70,433	Safety Net Clinic
(90) The Center for Family Resources Inc995 Roswell St 100 Marietta,GA30060	58-0876634	501(c)(3)	50,000	Building Strong Comm
(91) The Community Fdn Greater Atlanta Inc50 Hurt Plaza 449 Atlatnta,GA30303	58-1344646	501(c)(3)	1,175,000	The Centers of Hope
(92) The Corporation of Mercer University3001 Mercer University Dr Atlanta,GA30341	58-0566167	501(c)(3)	30,000	KP Pharm Endowment
(93) The Environmental Fund for Georgia Inc1447 Peachtree St 214 Atlanta,GA30309	58-2022001	501(c)(3)	97,910	2011 KP CorpContrib
(94) The Henry W Grady Health System Fdn50 Hurt Plaza 803 Atlanta,GA30303	58-2130437	501(c)(3)	2,023,500	Ambulatory Care Ctr
(95) The Leukemia & Lymphoma Society Inc3715 Northside Pkwy Bldg 400 300 Atlanta,GA30327	13-5644916	501(c)(3)	25,500	Pt Financial Aid Prg
(96) The Morehouse School Of Medicine Inc720 WestviewDr SW 238 Atlanta,GA30310	58-1438873	501(c)(3)	160,000	Strategic Partnershp
(97) The Sheltering Arms385 Centennial Olympic Park Dr Atlanta,GA30313	58-0566236	501(c)(3)	20,000	Operation StoryBook
(98) Trees Atlanta Inc225 Chester Ave Atlanta,GA30316	58-1584758	501(c)(3)	90,000	Docent Education
(99) United Way of Metropolitan Atlanta Inc100 Edgewood Ave NE Atlanta,GA30303	58-0566194	501(c)(3)	800,000	Healthy Communities
(100) University of Georgia Fdn394 S Milledge Ave 100 Athens,GA30602	58-6033837	501(c)(3)	25,000	KP Pharm Endowment
(101) University of West Georgia Fdn Inc1601 Maple St Carrollton,GA30118	58-6056464	501(c)(3)	20,000	KP Nurse Scholarship
(102) Voices for Georgia's Children100 Edgewood Ave NE 1580 Atlanta,GA30303	02-0678823	501(c)(3)	64,987	Advocacy & Consumer
(103) Year Up Inc730 Peachtree St Atlanta,GA30308	04-3534407	501(c)(3)	28,540	Literacy & Preventn
(104) YMCA of Metropolitan Atlanta Inc100 Edgewood Ave 1100 Atlanta,GA30303	58-0566253	501(c)(3)	300,000	HEAL Fund
(105) YWCA Greater Atlanta957 N Highland Ave NE Atlanta,GA30306	58-0593442	501(c)(3)	50,000	ENCOREplus Program
(106) YWCA NW Georgia48 Henderson St SW Marietta,GA30064	58-0617782	501(c)(3)	37,500	Operating Support

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

106

Enter total number of other organizations listed in the line 1 table ......................... . Bullet Image

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2011

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
PROCEDURES FOR MONITORING THE USE OF GRANTS	SCHEDULE I, PART I, LINE 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 $100K) may require quarterly progress reports.

Schedule I (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

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

2011

Open to Public Inspection

Name of the organization

KAISER FDN HEALTH PLAN OF GEORGIAINC

Employer identification number

58-1592076

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all the expenses described above? If "No," complete Part III to explain....

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? ....

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. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? ...............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? ........

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.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

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 ............

Yes

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 Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 50053T

Schedule J (Form 990) 2011

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.

(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 as deferred in prior Form 990
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1) Peter Andruszkiewicz	(i) (ii)	0 162,469	0 241,999	0 230,261	0 130,331	0 7,677	0 772,737	0 220,256
(2) Dawn Bading	(i) (ii)	0 185,982	0 37,951	0 31,137	0 53,177	0 16,706	0 324,953	0 0
(3) Frank Boone	(i) (ii)	0 0	0 0	0 185,876	0 32,479	0 14,299	0 232,654	0 0
(4) James Cullinan	(i) (ii)	0 198,066	0 64,804	0 15,963	0 49,558	0 16,264	0 344,655	0 0
(5) Lori k Ehrlich	(i) (ii)	0 85,650	0 235,066	0 2,918	0 11,109	0 16,456	0 351,199	0 0
(6) George Halvorson	(i) (ii)	0 1,215,613	0 5,039,506	0 1,606,796	0 61,308	0 13,287	0 7,936,510	0 0
(7) Carrie J Jennison	(i) (ii)	0 363,589	0 171,682	0 82,005	0 70,693	0 12,994	0 700,963	0 0
(8) Jonna Kirkwood	(i) (ii)	0 213,059	0 27,368	0 17,426	0 68,584	0 17,725	0 344,162	0 0
(9) Kerry Kohnen	(i) (ii)	0 356,960	0 188,914	0 149,505	0 126,718	0 14,839	0 836,936	0 81,203
(10) Kathryn Lancaster	(i) (ii)	0 630,520	0 907,953	0 570,629	0 276,632	0 12,994	0 2,398,728	0 529,003
(11) Donna Lynne	(i) (ii)	0 476,108	0 475,000	0 363,809	0 208,108	0 14,839	0 1,537,864	0 323,554
(12) Kirkland McGhee	(i) (ii)	0 192,809	0 22,776	0 3,198	0 21,176	0 17,265	0 257,224	0 0
(13) Thomas Meier	(i) (ii)	0 314,471	0 339,188	0 148,588	0 97,808	0 12,994	0 913,049	0 113,944
(14) Carolyn J Mustille	(i) (ii)	0 197,238	0 15,400	0 54,731	0 76,393	0 13,074	0 356,836	0 0
(15) Donald Orndoff	(i) (ii)	0 376,297	0 235,328	0 22,649	0 124,482	0 13,517	0 772,273	0 0
(16) J Neal Purcell	(i) (ii)	13,000 221,858	0 0	0 0	0 0	0 0	13,000 221,858	0 0
(17) Arthur Southam	(i) (ii)	0 741,374	0 1,175,000	0 732,850	0 336,623	0 12,064	0 2,997,911	0 688,121
(18) Deborah Stokes	(i) (ii)	0 315,132	0 337,575	0 67,595	0 105,024	0 12,994	0 838,320	0 48,521
(19) Beverly Thomas	(i) (ii)	0 179,569	0 45,214	0 75,425	0 61,335	0 17,265	0 378,808	0 56,607
(20) Bernard Tyson	(i) (ii)	0 892,605	0 1,290,000	0 617,691	0 469,158	0 12,994	0 3,282,448	0 587,707
(21) Michael Bernard Wathen	(i) (ii)	0 132,539	0 0	0 11,445	0 24,500	0 17,265	0 185,749	0 0
(22) Steven Zatkin	(i) (ii)	0 4,500	0 542,685	0 26,936	0 66,393	0 10,532	0 651,046	0 0
(23) Victoria Zatkin	(i) (ii)	0 192,675	0 85,692	0 36,401	0 82,570	0 1,961	0 399,299	0 0
(24) Mark Zemelman	(i) (ii)	0 398,502	0 259,500	0 120,574	0 179,338	0 12,585	0 970,499	0 80,051

Schedule J (Form 990) 2011

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.

Identifier	Return Reference	Explanation
SCHEDULE J, PART II		Peter Andruszkiewicz- Regional President of Georgia until 4/26/11. Kerry Kohnen- Regional President of Georgia beginning 5/30/11. Steve Zatkin- General Council to 6/30/10; consultant 3/4/11 to present. SCHEDULE J, PART I, LINE 3 TOP MANAGEMENT OFFICIALS' COMPENSATION Kaiser Foundation Health Plan of Georgia 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, PART I, LINE 4A	SEVERANCE PAYMENT	FRANK BOONE $185,608 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, PART I, LINE 4B	SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENT	GEORGE HALVORSON $1,500,000 FRANK BOONE 62 KATHRYN LANCASTER 529,350 THOMAS MEIER 114,428 DEBORAH STOKES 48,521 STEVEN ZATKIN 4,891 MARK ZEMELMAN 81,133 ARTHUR SOUTHAM 688,121 PETER ANDRUSZKIEWICZ 220,256 KERRY KOHNEN 81,203 BERNARD TYSON 587,707 CAROLYN MUSTILLE 238 BEVERLY THOMAS 56,607 DONNA LYNNE 323,554 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, PART I, LINE 7	NON-FIXED PAYMENTS	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) 2011

Additional Data

Software ID:
Software Version:

- TIN:

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

2011

Open to Public
Inspection

Name of the organization

KAISER FDN HEALTH PLAN OF GEORGIAINC

Employer identification number

58-1592076

Identifier	Return Reference	Explanation
FORM 990, PART VI, LINE 4	CHANGES TO GOVERNING DOCUMENTS	On June 24, 2010 the member of the Corporation approved an amendment to Article FIVE of the Restated Articles of Incorporation to add a Chief Executive Officer as one of the officers of the Corporation whose removal shall require the approval of the member, which amendment was approved by the Board of Directors of the Corporation on November 17, 2010, and filed with the Secretary of State of Georgia on January 25, 2011; On December 1, 2011 the member of the Corporation approved amendments to Articles Four, Five and Seven of the Restated Articles of Incorporation of the Corporation to (a) revise the purpose section for consistency with the Articles of Incorporation of Kaiser Foundation Health Plan, Inc. (the member of the Corporation) and its other Health Plan subsidiaries, including making a reference to the Internal Revenue Code (Section 501(c)(3)) consistent with other references in the Articles; (b) add the provision that removal of "any" President shall require the approval of the member; (c) add the provision that compensation of "any" President shall require the approval of the member; and (d) expressly state that the corporation is prohibited from engaging in activities not permitted by Section 501(c)(3) of the Internal Revenue Code and to specifically state that the corporation shall not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office; which amendment was approved by the Board of Directors of the Corporation on December 7, 2011, filed with the Commissioner of Insurance on January 20, 2012, published, and resubmitted to the Commissioner of Insurance on April 3, 2012. Receipt of the Secretary of State's Certificate of Amendment is pending; and On March 3, 2011, Article E., Officers, of the Bylaws of the Corporation was amended by the member to (a) provide that the officers of the Corporation may include one or more Group Presidents (Section E-1, Officers); (b) add a new Section E-8, Group President and/or Regional President, to describe the duties and responsibilities of those positions; (c) provide that the President shall be the Chief Operating Officer of the Corporation (Section E-7, President); and (d)) provide clarification regarding leadership in the event of the absence or disability of the President (Section D-9, Executive Vice President or National Senior Vice President); and (e) to change the reference to "the President" in Sections E-3, E-4 and E-11 to "any President"; which amendments were approved by the Board of Directors of the Corporation on April 6, 2011; and On June 23, 2011, minor technical amendments to the Bylaws of the Corporation were approved by the member to make them more consistent with the Bylaws of the member and its Health Plan subsidiaries and with organizational policies and current law, which amendments were approved by the Board of Directors of the Corporation on June 29, 2011. None of the changes were significant; and On December 1, 2011, amendments to Article A, Purpose, of the Bylaws of the Corporation were approved by the member to (a) more clearly state the purposes in one Purpose section (A-1, former section A-2 was deleted); (b) expressly state that the corporation is prohibited from engaging in activities not permitted by Section 501(c)(3) of the Internal Revenue Code and to specifically state that the corporation shall not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office (Section A-3 Nonprofit Character - now A-2); (c) make a reference to the Internal Revenue Code consistent with other references in the Bylaws (Section A-4 Disposition of Assets on Liquidation or Dissolution - now A-3); and (d) be consistent with current legal standards (Section A-5 Non-discrimination - now A-4); which amendments were approved by the Board of Directors of the Corporation on December 7, 2011.
FORM 990, PART VI, LINE 6	MEMBERS OR STOCKHOLDERS	KAISER FOUNDATION HEALTH PLAN, INC IS SOLE MEMBER Upon dissolution, remaining assets shall be distributed to a 501(c)(3) organization
FORM 990, PART VI, LINE 7A	ELECT MEMBERS OF THE GOVERNING BODY	Kaiser Foundation Health Plan, Inc appoints the Board of Directors (and fills vacancies and has authority to remove Directors)
FORM 990, PART VI, LINE 7B	MEMBERS' APPROVAL	The following actions of the corporation require the approval of the member. Typically the member (KFHP) would approve actions requiring member approval and the Board of Directors of KFHP-GA also would approve or ratify the action: 1. Removal of the Chairman of the Board, CEO, or Regional President. The compensation of the Regional President and other executive officers of the corporation shall be approved by the member's Compensation Committee; 2. The sale, lease, exchange, or other disposition of, the mortgage, pledge or dedication to the repayment of indebtedness (whether with or without recourse), or any other encumbrance of property of the corporation, or the acquisition of assets, whether or not in the usual or regular course of the corporation's activities, where the fair market value of such corporate property or assets being disposed of, acquired or encumbered exceeds 10% of the value of the assets of the corporation as reflected in the most recent annual or quarterly financial statements that are available on the date immediately preceding the date of the relevant transaction shall require the approval of the member 3. Capital expenditures that exceed $25 million shall require the approval of the member 4. The issuance of tax-exempt bonds 5. Amendments to Article C (Members), D (Directors) and H (Amendment and Effect of Bylaws) of the Bylaws and amendments to the Articles of Incorporation. Article A (Purposes), B (Offices), E (Officers), F (Committees) and G (Miscellaneous) of the Bylaws may be amended by the Board of KFHP-GA acting alone and do not require ratification by the member.
FORM 990, PART VI, LINE 11B	FORM 990 REVIEW PROCESS	1. Community benefit details are presented to the community benefit committee of the board for review 2. The tax return is reviewed and signed by a Pricewaterhousecoopers tax advisor 3. The complete tax return is reviewed and signed by an officer or a member of management designated by an officer 4. A compact disk containing the signed return is provided to each board member prior to filing
FORM 990, PART VI, LINE 12C	COMPLIANCE ENFORCEMENT	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. Retaliation is prohibited. 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 or manage 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 SVP 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 process 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 informs 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: - Oral discussion and/or warning by the employee's immediate supervisor or higher level manager to correct the problem - Written notice, with or without final warning - Paid or unpaid suspension, with or without final warning - Termination of employment
FORM 990, PART VI, LINE 15A/B	COMPENSATION DETERMINATION	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, LINE 19	PUBLIC INSPECTION	Governing documents are available as provided to state Dept. of Insurance and maintained on state agency website or upon request. Conflict of Interest 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 upon request. To request copies contact: VP - National Tax Compliance Kaiser Foundation Health Plan and Hospitals One Kaiser Plaza, Ste 15L Oakland, CA 94612
FORM 990, PART VII, SECTION A, COLUMN B	HOURS FOR RELATED ORGANIZATIONS	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	OTHER CHANGES IN NET ASSETS OR FUND BALANCES	CHANGE IN UNREALIZED GAIN/LOSS ON INVESTMENTS <$ 542,029> CHANGE IN OTHER COMPREHENSIVE INCOME < 13,935,473> GAIN/LOSS ON INVESTMENTS - TAX < 679,945> GAIN/LOSS ON INVESTMENTS - BOOK 959,929 OTTI LOSSES < 494,271> ____________ TOTAL <$14,691,789>
FORM 990, PART III, LINE 4A-D		2011 COMMUNITY BENEFIT REPORT KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC. Kaiser Foundation Health Plan of Georgia, Inc. or "Georgia Health Plan" is a tax-exempt subsidiary health plan of Kaiser Foundation Health Plan, Inc. (KFHP). Kaiser Foundation Health Plan of Georgia, as well as Kaiser Foundation Hospitals (KFH) are nonprofit corporations that are part of the integrated health care delivery system known as the Kaiser Permanente Medical Care Program or "Kaiser Permanente." In 2011, Georgia Health Plan served 238,078 members and has 2,288 full-time administrative, clerical and technical employees. Georgia Health Plan provides and arranges comprehensive health care services for members on a predominantly prepaid basis. Health Plan fulfills its contractual obligations to group and individual members by contracting with KFH and a Permanente Medical Group to provide the required health care services. Membership in KFHP and its health plan subsidiaries is available without regard to sex, race, religion, ethnic background, sexual orientation, and occupational status or income level. Health Plan members are broadly representative of the various ages, social and income groups within the areas it serves. 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 key focus areas. THE COMMUNITY BENEFIT PROGRAM IN THE GEORGIA REGION In 2011, Georgia Health Plan expended $32.8 million to support community benefit activities. A breakdown of the 2011 Community Benefit dollars attributable to the Georgia Health Plan is included in Attachment A. The following identifies many of the signature community benefit programs and services grouped according to the national streams of work funded by Georgia Health Plan. CARE AND COVERAGE FOR LOW-INCOME PEOPLE There are roughly 49 million people in America without access to health care or coverage. Uninsured, low-income individuals and families who are not eligible for public programs often have to rely on traditional charity care. Frequently, individuals in this situation may wait to seek medical care until their conditions become critical, and end up in hospital emergency rooms for treatment of conditions that are preventable or easily treated in earlier stages. In 2011, the Georgia Health Plan expended $13.3 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 a by Permanente provider. Charitable Care (Medical Financial Assistance and Charitable Health Coverage Programs) In the Georgia Region, Health Plan provides charity care to low-income vulnerable populations through the Medical Financial Assistance and Charitable Coverage Program. In 2011, the Georgia Health Plan spent approximately $11 million on under- and uninsured residents. - Medical Financial Assistance Program The Georgia Health Plan's Medical Financial Assistance Program provides temporary financial assistance and/or medically necessary services, medications or supplies to patients with a demonstrated financial need. Patients must receive health care services at a Kaiser Permanente facility and/or from a Kaiser Permanente provider. Kaiser Permanente's charity care program also includes discounted charges for uninsured patients below 400% federal poverty guidelines and aligned contracted collection agency practices with Kaiser Permanente social values. In 2011, this program assisted 2,175 patients. - Charitable Health Coverage Program Charitable Health Coverage (CHC) is our unique approach to caring for low-income uninsured persons in our communities. 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 Kaiser Permanente Bridge Program enrolls and subsidizes for up to two years, 95% of the premium for income-eligible individuals who do not have access to any other form of health insurance. This program partners with community agencies to identify eligible clients whose income falls at or below 300% of the federal poverty guidelines. By year-end 2011, the Georgia Health Plan had 1,027 individuals in the Kaiser Permanente Bridge Program. 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). The Georgia Health Plan spent approximately $5.6 million on community health initiatives during 2011. Community Health Education and Prevention Programs The Georgia Health Plan offered a variety of health education classes, events, and programs for the general public. During 2011, the Health Education Department organized numerous health fairs and screenings at Health Plan medical offices which were open to the general public. Expenditures in this category exclude program cost for health education programs targeting or restricted to Health Plan members. The following is an example of a community partnership aimed at promoting health and well being. - The Georgia Health Plan is the sponsor of the Green Market, weekly farmers' market (May-December) offering a variety of organic fruits, vegetables, fresh cut flowers, baked goods as well as healthy cooking demonstrations and fitness classes. In 2011, 77,500 people attended the Green Market. - In 2011 KPGA offered a variety of healthy living classes and customized programs to over 1,050 clients of 3 Metro Atlanta "Y" branches who serve vulnerable communities.
Grants and Donations for Community Health Initiatives		The Georgia Health Plan (KPGA) contributed $5.6 million to 76 nonprofit organizations to support a variety of community health initiatives. Following are examples of two programs funded in 2011. - Supported by a Kaiser Permanente grant, the Chattahoochee Nature Center (CNC) provided fresh produce for a local food pantry. With a $32,553 Kaiser Permanente grant, CNC continued its soccer-field-turned-community garden project. The garden produced over 5,000 pounds and 30,000 servings of fresh, seasonal produce in 2011. The produce benefited clients of another KPGA grantee, the nearby North Fulton Community Charities, a nonprofit that provides food, clothing and short-term emergency assistance to low-income families. Over 5,000 clients received produce in 2011, and participated in educational workshops on healthy eating and active living provided by CNC. - KPGA is addressing the region's childhood obesity challenge (almost 38% of children younger than 17 are obese) through a project implemented by the YMCA of Metropolitan Atlanta. The initiative tested and put into practice techniques that minimize health risks related to overweight/obesity. The goal is to improve health outcomes for youth (ages 2 to 16) through programs that promote healthy eating, physical activity and behavior change that establish lifelong habits of health and wellness. The contribution supported the study's first phase, which focuses on 3 to 5 year olds, and funded curriculum development and strategy implementation to prevent and address obesity in YMCA pre-school Head Start students. 526 children participated in the project's control and intervention groups at nine YMCA sites in 2011. 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. Grants and Donations for Safety Net Partnerships The Georgia Health Plan contributed $4.9 million to 33 organizations that deliver medical or dental care services to uninsured people in community settings, primarily safety net clinics in Georgia. Following are two community organizations supported by these grants in 2011 - Nationally, Georgia is ranked 36th in the percent of its population that has access to primary care. A Kaiser Permanente Georgia grant to the United Way of Metropolitan Atlanta created the Primary Care Access program, and served over 2,700 people in 2011. The initiative expands access to care in five metro Atlanta counties. The program helped people access primary care and addresses the dramatic increase in patients seeking care that community clinics have recently experienced. Counties were selected based on residents' health status, income levels, and the capacity of community-based health care organizations. Because of the project, patients who have no other options for care received services through new access points for primary care. - Community clinics are a vital part of the safety net providing healthcare to thousands of under- and uninsured patients each year. Hands of Hope Clinic is such a facility. With a $37,750 Kaiser Permanente Georgia grant, the clinic launched their "Diabetic Self-Care Program, which provided American Diabetes Association-approved diabetes education to patients. Diabetes is a leading cause of death among Georgians, and is linked to health disparities in the Kaiser Permanente service area. The grant made possible health care for 120 diabetic patients who might not otherwise receive appropriate care. By providing patient education, screening, monitoring, and medication Hands of Hope is improving its patients' health, but is also freeing the local hospital emergency room to treat patients with urgent health crises. DEVELOPING AND DISSEMINATING KNOWLEDGE Kaiser Permanente aims to improve health by sharing its knowledge, educating practitioners, advancing research, empowering consumers, and informing policymakers about the evidence base for care and health. The Georgia Health Plan spent $7.6 million to support programs and services for the development and dissemination of knowledge and provided grants and donations to nonprofit organizations. Clinical and Health Services Research The Georgia Health Plan's Center for Health Research department partners with research programs at Emory University, Morehouse School of Medicine, Centers for Disease Control and Prevention (CDC) and the Georgia Department of Human Resources, Division of Public Health. During 2011, the Center for Health Research participated in 97 studies and published results in 23 peer-reviewed publications. Following are examples of studies conducted in 2011 - Three Community Benefit-funded studies focused on conditions affecting vulnerable populations in Georgia. The studies involved vulnerable populations and 1) Hypertension, 2) Chronic Kidney Disease - especially among Diabetics and 3) Maternal Influenza Vaccinations on Fetal and Infant Outcomes. Educational Theatre Programs (ETP) The Georgia Health Plan offered free, award-winning health education plays for youth and adults. Kaiser Permanente's Educational Theatre Programs offers a unique series of dynamic theatre programs with compelling health messages to reach children, teens and adults. These national award-winning plays promote individual responsibility for one's health, instill positive attitudes about healthy lifestyle choices and demonstrate the benefits of positive action. Topics addressed in the performances range from AIDS awareness and stress management to grief counseling and health and wellness messages, related to nutrition and asthma education. All programs are offered free of charge as a community benefit of Kaiser Permanente. In 2011, the program reached approximately 59,856 children and adults through 585 programs. Training and Education of Health Care Professionals In 2011, the Georgia Health Plan spent $282,214 to support the education and training of health care professionals. The following provides a description of two efforts undertaken to alleviate health care workforce shortages in the community. Pharmacy Residency Program The Pharmacy Residency Program helps students gain post graduate training experience in a managed care setting. Training components of the Georgia Health Plan program include: management and improvement of medication use through evidence-based patient-centered therapy with interdisciplinary teams; medication and practice-related education, population-based care and formulary management. In 2011, four interns participated in the program. Grants and Donations for Knowledge Dissemination The Georgia Health Plan donated $874,487 in charitable contributions to 15 nonprofit organizations for the dissemination of evidence-based studies which informed the community about health care public policy and educational opportunities for individuals seeking a career as a health care professional. Following is an example of one of the programs supported in 2011 - Voices for Georgia's Children provides research-based information that helps policymakers and Georgia's citizens make informed decisions about policies affecting children. Kaiser Permanente Georgia granted the organization $64,987 to use education and advocacy to decrease the number of uninsured children in Georgia. The organization provided culturally and linguistically-appropriate child health insurance eligibility and enrollment materials and partnered with community-based organizations to ensure that eligible children were enrolled in health insurance programs. - In addition, the Georgia Health Plan awarded $692,500 in grants to local colleges and universities to address health care worker shortages. We supported scholarship programs at 8 nursing programs, the Morehouse School of Medicine and two pharmacy programs, which awarded a total of 32 nursing, pharmacy, and medical student scholarships. Finally, we contributed $100,000 to the Satcher Health Leadership Institute at the Morehouse School of Medicine to address mental health disparities, and facilitate the integration of primary and behavioral health care.
Other Community Benefit		The Georgia Health Plan spent $1.2 million on other community benefit activities and programs beyond the national streams of work. Self-Sufficiency Programs The Georgia Health Plan spent $100,492 to support seven INROADS interns in 2011. The INROADS program is aimed at improving education and job skills or providing employment opportunities for targeted populations. INROADS is an organization focused on developing minority college students for leadership roles in corporations and in the community. Student interns typically work two to five summers with the organization with the goal of permanent placement upon graduation from college. Community Giving Campaign The Georgia Region's Community Giving Campaign is the employee's charitable giving program. Employees contribute to United Way and Earthshare through payroll deductions, direct gifts and special event fundraising. The amount reported is to cover administrative expenses for operating the campaign. Other Community Grants and Donations The Georgia Health Plan contributed $114,000 to two nonprofit community organizations in support of a variety of other programs and services for vulnerable populations. Following are highlights of one of the programs funded: - The Martin Luther King, Jr. Center for Nonviolent Social Change provides education about Dr. King's philosophy and continues his work to promote research, education and training. Each year, the Center hosts the Salute to Greatness Awards Dinner to honors recipients of the Salute to Greatness Award, the Center's highest recognition afforded individuals and institutions that embody the principles espoused by Dr. King. Kaiser Permanente Georgia joined with other local and national companies to support the King Center, and award recipients who help improve quality of life through their efforts. Regional Community Benefit Operations The Georgia Health Plan has a Community Benefit Department with nine employees to support regional community benefit programs and coordinate CB initiatives including the Educational Theatre Programs. In addition, there are many other Health Plan personnel who collaborate to help manage community benefit programs like Charity Care, Charitable Health Coverage. ATTACHMENT A 2011 COMMUNITY BENEFIT INVESTMENT - GEORGIA REGION The following chart summarizes 2011 Community Benefit investments by the Georgia Health Plan. The investments in the community reflected in the chart are unaudited. CARE AND COVERAGE Charitable Care & Coverage Programs $11,047,959 Government Sponsored Program 1,719,080 Grants/Donations for Care and Coverage 500,000 Subtotal: $13,267,039 COMMUNITY HEALTH INITIATIVES Community Health Education $12,262 Grants/Donations for Community Health Initiatives 5,635,675 Subtotal: $5,647,937 SAFETY NET PARTNERSHIPS Grants/Donations for Safety Net Partnerships $4,908,112 Safety Net CB Operations 211,653 Subtotal: $5,119,765 KNOWLEDGE DISSEMINATION Medical Research $5,506,146 Educational Theatre Program 890,350 Health Care Training & Education Programs 282,214 Grants/Donations for Knowledge Dissemination 874,487 Subtotal: $7,553,197 OTHER COMMUNITY BENEFITS Self Sufficiency Programs $100,492 Grants/Donations for Other Community Benefits 114,000 Other CB Operations 970,783 Subtotal: $1,185,275 TOTAL $32,773,213
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Peter Andruszkiewicz TITLE:Region President - Georgia HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Kerry Kohnen TITLE:Region President - Georgia HOURS:10
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Jeffrey Koplan TITLE:Director HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Donna Lynne TITLE:Director HOURS:46
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:J. Neal Purcell TITLE:Director HOURS:8
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Bernard Tyson TITLE:Director & Chair HOURS:45
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:George Halvorson TITLE:Chairman and CEO HOURS:45
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Kathryn Lancaster TITLE:EVP & CFO HOURS:46
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Kirkland McGhee TITLE:VP, Regional Counsel - GA HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Thomas Meier TITLE:SVP, Corporate Treasurer HOURS:47
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Donald Orndoff TITLE:SVP, NFS HOURS:45
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Arthur Southam TITLE:EVP, Health Plan Operations HOURS:45
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Deborah Stokes TITLE:SVP, CC & CAO HOURS:46
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Victoria Zatkin TITLE:Assistant Secretary HOURS:46
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Mark Zemelman TITLE:SVP, Gen Counsel & Secretary HOURS:47
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:James Cullinan TITLE:VP, Mktg Sales & Bus Dev't HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Carrie J Jennison TITLE:VP, CFO - Georgia HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Michael Bernard Wathen TITLE:VP, HP Svcs Admin - GA HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Dawn Bading TITLE:VP, Human Resources - GA HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Lori k Ehrlich TITLE:Sr Sales Exec. - Large Group HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Jonna Kirkwood TITLE:VP, Operations - GA HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Carolyn J. Mustille TITLE:VP, Quality, Service & Nursing HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Beverly Thomas TITLE:VP, Community & Public Affairs HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Frank Boone TITLE:VP, Finance HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Steven Zatkin TITLE:Consultant 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) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

KAISER FDN HEALTH PLAN OF GEORGIAINC

Employer identification number

58-1592076

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

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
(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	Yes	No
(1) KAISER FOUNDATION HEALTH PLAN INC ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 94-1340523	HEALTH CARE	CA	501(c)(3)	9	NA		No
(2) KAISER FOUNDATION HOSPITALS ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 94-1105628	HEALTH CARE	CA	501(c)(3)	3	KFHP INC	Yes
(3) KAISER FDN HEALTH PLAN OF COLORADO ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 84-0591617	HEALTH CARE	CO	501(c)(3)	9	KFHP INC	Yes
(4) KFHP OF THE MID-ATLANTIC STATES ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 52-0954463	HEALTH CARE	MD	501(c)(3)	9	KFHP INC	Yes
(5) KAISER FDN HEALTH PLAN OF THE NORTHWEST ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 93-0798039	HEALTH CARE	OR	501(c)(3)	9	KFHP INC	Yes
(6) KAISER FDN HEALTH PLAN OF OHIO ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 34-0922268	HEALTH CARE	OH	501(c)(3)	9	KFHP INC	Yes
(7) KAISER HEALTH PLAN ASSET MANAGEMENT INC ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 94-3299124	ASSET MGMT	CA	501(c)(3)	11 - I	KFHP INC	Yes
(8) LOKAHI ASSURANCE LTD ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 91-2171891	RISK MGMT	HI	501(c)(3)	11 - I	KFHP INC	Yes
(9) KAISER HOSPITAL ASSET MANAGEMENT INC ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 94-3299125	ASSET MGMT	CA	501(c)(3)	11 - I	KF HOSPITALS	Yes
(10) CAMP BOWIE SERVICE CENTER ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 94-3299123	ADMIN	CA	501(c)(3)	11 - I	KFHP INC	Yes
(11) OHP ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 93-0480268	LEASING	WA	501(c)(3)	11 - I	KFHP INC	Yes
(12) KAISER HEALTH ALTERNATIVES ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 93-0954562	HEALTH CARE	OR	501(c)(3)	9	KFHP INC	Yes
(13) 1800 HARRISON ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 94-3317484	FINANCING	CA	501(c)(3)	11 - II	KFHP INC	Yes
(14) KAISER HOSPITAL ASSISTANCE CORPORATION ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 31-1779500	FINANCING	CA	501(c)(3)	11 - III-O	KF HOSPITALS	Yes

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2011

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 VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) HCMS LLC ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 20-3924985	CASE MANAGEMENT	CA	NA	NONE	0	0			0			0 %
(2) KAISER PERMANENTE VENTURES LLC ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 27-2252521	INVESTMENTS SVC	CA	NA	NONE

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) OAK TREE ASSURANCE LTD ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 03-0329760	INUSRANCE	VT	NA	C CORP	0	0	0 %
(2) KAISER PERMANENTE INSURANCE COMPANY ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 94-3203402	INUSRANCE	CA	NA	C CORP
(3) KAISER PROPERTY SERVICES INC ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 94-3259432	REAL ESTATE	CA	NA	C CORP
(4) ARCHIMEDES INC ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 20-3774729	CONSULTING	CA	NA	C CORP
(5) KAISER PERMANENTE INTERNATIONAL ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 94-3245176	CONSULTING	CA	NA	C CORP

Schedule R (Form 990) 2011

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

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 . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

Yes

l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

Yes

m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

r Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

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	b	54,155	per agreement
(2) kaiser foundation hospitals	e	11,290,667	per agreement
(3) kaiser foundation hospitals	i	177,170,027	per agreement
(4) Kaiser foundation health plan inc	k	6,802,359	per agreement
(5) KFHP of colorado	k	228,566	per agreement
(6) kfhp of the mid- atlantic states	k	1,149,007	per agreement
(7) kfhp of the northwest	k	163,772	per agreement
(8) kfhp of ohio	k	347,471	per agreement
(9) kaiser permanente insurance company	k	4,154,185	per agreement
(10) kaiser foundation health plan inc	l	25,285,720	per agreement
(11) kaiser foundation hospitals	l	71,035,877	per agreement
(12) kfhp of colorado	l	194,970	per agreement
(13) kfhp of the mid-atlantic states	l	609,177	per agreement
(14) kfhp of the northwest	l	15,328	per agreement
(15) kfhp of Ohio	l	149,026	per agreement
(16) camp bowie service center	l	3,502,819	per agreement
(17) kaiser permanente insurance company	l	24,350,616	per agreement
(18) lokahi assurance ltd	l	20,679,149	per agreement
(19) oak tree assurance ltd	l	967,500	per agreement
(20) ordway indemnity	l	498,900	per agreement
(21) kfhp of colorado	n	422,638	per agreement
(22) kaiser foundation health plan inc	o	19,556,476	per agreement
(23) kaiser foundation hospitals	o	51,599,405	per agreement
(24) kfhp of colorado	o	123,330	per agreement
(25) kfhp of the mid-atlantic states	o	65,309	per agreement
(26) kfhp of the northwest	o	2,654	per agreement
(27) kfhp of ohio	o	18,601	per agreement
(28) camp bowie service center	o	314,348	per agreement
(29) kaiser foundation health plan inc	p	11,149,619	per agreement
(30) kaiser foundation hospitals	p	29,663,609	per agreement
(31) kfhp of colorado	p	12,846	per agreement
(32) kfhp of the mid-atlantic states	p	144,216	per agreement
(33) kfhp of the northwest	p	42,020	per agreement
(34) kfhp of ohio	p	37,125	per agreement
(35) kaiser permanente insurance company	p	18,115,403	per agreement
(36) lokahi assurance ltd	p	2,863,985	per agreement
(37) oak tree assurance ltd	p	475,218	per agreement
(38) kaiser foundation health plan inc	q	3,051	per agreement
(39) kaiser foundation hospitals	q	183,463,568	per agreement
(40) lokahi assurance ltd	q	4,833,000	per agreement
(41) kaiser foundation health plan inc	r	4,946	per agreement

Schedule R (Form 990) 2011

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)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2011

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

Software ID:
Software Version:

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
3	Number of voting members of the governing body (Part VI, line 1a).....	3	5
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	2
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...	5	2,161
6	Total number of volunteers (estimate if necessary) ....	6	754
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	0

Sign Here

	Signature of officer	Date

	Type or print name and title.


4a	(Code: ) (Expenses $ 1,011,943,067 including grants of $ 0 ) (Revenue $ 1,087,051,961 )
	Member health care services and medical training for care improvement Kaiser Foundation Health Plan of Georgia, Inc. (KFHP of Georgia) provides 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 Georgia educates and trains medical students and other health care professionals and promotes scientific and nursing education in order to improve care. Additional information about Georgia Health Plan's charitable activities can be found in Schedule O, Community Benefit Report.

4b	(Code: ) (Expenses $ 11,589,112 including grants of $ 0 ) (Revenue $ 541,153 )
	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 facilities. In 2011 this program assisted 2,175 applicants. CHC - The Kaiser Permanente Bridge Program is uniquely designed to help uninsured; income eligible individuals obtain subsidized health care coverage for up to 24 months. As a community benefit, Kaiser Permanente subsidizes 95% of the premium. Community agencies partner to identify clients/students whose income falls at or below 300% of the federal poverty level and meet all other eligibility criteria. Throughout 2011, 2,617 individuals were enrolled in the Bridge Program and we ended the year with 1,027 members. Additional information about Georgia Health Plan's charitable activities can be found in Schedule O, Community Benefit Report.

4c	(Code: ) (Expenses $ 12,022,634 including grants of $ 12,022,634 ) (Revenue $ 0 )
	Grants and Donations The Georgia Region Health Plan offered a variety of health education classes, events and programs to both members and the general public. Classes included heart health, healthy cooking, and benefits of physical activity, smoking cessation, weight loss, parenting, diabetes, stress management, and managing chronic illness. In 2011 KPGA offered a variety of healthy living classes and customized programs to over 1,050 clients of 3 Metro Atlanta "Y" branches who serve vulnerable communities- (Villages of Carver Family, Eastlake and Andrew Young). The Georgia region also sponsored the Green Market, a weekly farmers' market (May-December) offering a variety of organic fruits, vegetables, fresh cut flowers, baked goods as well as healthy cooking demonstrations and Tai Chi Classes. In 2011, 77,500 people attended the Green Market. Additional information about Georgia Health Plan's charitable activities can be found in Schedule O, Community Benefit Report.

	(Code: ) (Expenses $ 4,463,762 including grants of $ 0 ) (Revenue $ 0 )
	SCH. O, COMMUNITY BENEFIT REPORT

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 4,463,762 including grants of $ 0 ) (Revenue $ 0 )
4e	Total program service expenses$ 1,040,018,575

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)				(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
(A) Name and Title
(18) Michael Bernard Wathen VP, HP Svcs Admin - GA	30.0	X			0	143,984	41,765
(19) Dawn Bading VP, Human Resources - GA	30.0		X		0	255,070	69,883
(20) Lori k Ehrlich Sr Sales Exec. - Large Group	30.0		X		0	323,634	27,565
(21) Jonna Kirkwood VP, Operations - GA	30.0		X		0	257,853	86,309
(22) Carolyn J Mustille VP, Quality, Service & Nursing	30.0		X		0	267,369	89,467
(23) Beverly Thomas VP, Community & Public Affairs	30.0		X		0	300,208	78,600
(24) Frank Boone VP, Finance	0.0			X	0	185,876	46,778
(25) Steven Zatkin Consultant	0.0			X	0	574,121	76,925

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	25,000	24,960,594	3,046,087

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	2,350,668	8,056,693
9	Program service revenue (Part VIII, line 2g) .........	945,171,878	1,087,593,114
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	5,931,849	4,236,372
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	7,140,775	0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	960,595,170	1,099,886,179
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	9,046,312	12,022,634
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)	166,674,729	182,121,879
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	938,805,370	935,402,301
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,114,526,411	1,129,546,814
19	Revenue less expenses. Subtract line 18 from line 12.......	-153,931,241	-29,660,635
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	372,483,994	375,804,045
21	Total liabilities (Part X, line 26).............	420,376,284	468,048,759
22	Net assets or fund balances. Subtract line 21 from line 20.....	-47,892,290	-92,244,714

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		7,784,437
e	Government grants (contributions)1e		8,919

f	All other contributions, gifts, grants, and similar amounts not included above1f		263,337
g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			8,056,693
			Business Code
2a	MEMBERS HEALTH CARE		621,400	831,545,002	831,545,002
b	SUPPLEMENTAL CHARGE		621,400	49,055,815	49,055,815
c	NON-PLAN & INDUSTRIAL		621,400	2,911,296	2,911,296
d	OTHER PROGRAM SERVICES		621,400	36,338,064	36,338,064
e	MEDICARE/MEDICAID PAYMENTS		621,400	167,742,937	167,742,937
f	All other program service revenue .
g	Total. Add lines 2a–2f........			1,087,593,114
3	Investment income (including dividends, interest
	and other similar amounts).....			3,549,083			3,549,083
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties............			0
		(i) Real	(ii) Personal
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss).......
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	66,000,908	10,464
b	Less: cost or other basis and sales expenses	65,320,963	3,120
c	Gain or (loss)	679,945	7,344
d	Net gain or (loss)..........			687,289			687,289
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..			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...			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..			0
Miscellaneous Revenue			Business Code
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			0
12	Total revenue. See Instructions....			1,099,886,179	1,087,593,114		4,236,372


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			406,177	1	695,806
2	Savings and temporary cash investments .......			0	2	0
3	Pledges and grants receivable, net .........			0	3	0
4	Accounts receivable, net .........			26,718,979	4	32,310,378
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........			0	5	0
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 ..........			0	6	0
7	Notes and loans receivable, net .............			0	7	0
8	Inventories for sale or use ..............			9,806,294	8	10,527,838
9	Prepaid expenses and deferred charges ............			867,207	9	1,280,557
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	331,584,283
b	Less: accumulated depreciation. .....	10b	145,360,539	140,809,725	10c	186,223,744
11	Investments—publicly traded securities ..........			193,511,986	11	144,304,913
12	Investments—other securities. See Part IV, line 11 ......			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets .........			0	14	0
15	Other assets. See Part IV, line 11 ...........			363,626	15	460,809
16	Total assets. Add lines 1 through 15 (must equal line 34)...			372,483,994	16	375,804,045
17	Accounts payable and accrued expenses .			84,150,555	17	97,667,730
18	Grants payable ..........			0	18	0
19	Deferred revenue ..........			9,470,758	19	16,107,012
20	Tax-exempt bond liabilities ..........			0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			0	21	0
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..			0	23	0
24	Unsecured notes and loans payable to unrelated third parties ....			0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.....			326,754,971	25	354,274,017
26	Total liabilities. Add lines 17 through 25.....			420,376,284	26	468,048,759
	Organizations that follow SFAS 117, check here 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 and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....			5,665,218	30	5,665,218
31	Paid-in or capital surplus, or land, building or equipment fund .....			0	31	0
32	Retained earnings, endowment, accumulated income, or other funds			-53,557,508	32	-97,909,932
33	Total net assets or fund balances .....			-47,892,290	33	-92,244,714
34	Total liabilities and net assets/fund balances .....			372,483,994	34	375,804,045