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

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2011
Open to Public Inspection
A For the calendar year, or tax year beginning 01-01-2011 and ending 12-31-2011
BCheck if applicable:
CName of organization
KAISER FDN HEALTH PLAN OF COLORADO
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
ONE KAISER PLAZA SUITE 15L
 
Room/suite
City or town, state or country, and ZIP + 4
OAKLAND, CA94612
D Employer identification number

84-0591617
E Telephone number

G Gross receipts $ 3,270,693,053
F Name and address of principal officer:
DONNA LYNNE
ONE KAISER PLAZA SUITE 15L
OAKLAND,CA94612
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
N/A
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1969
M State of legal domicile: CO
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: TO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a)..... 3 14
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 12
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ... 5 6,093
6 Total number of volunteers (estimate if necessary) .... 6 1,261
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 339,640
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b  
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 10,958,451 14,549,684
9 Program service revenue (Part VIII, line 2g) ......... 2,587,673,738 2,850,877,885
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 25,028,919 26,046,278
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 63,216 31,381
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 2,623,724,324 2,891,505,228
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 25,243,925 5,805,600
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) 558,866,327 607,324,341
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 1,995,063,535 2,224,868,677
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 2,579,173,787 2,837,998,618
19 Revenue less expenses. Subtract line 18 from line 12....... 44,550,537 53,506,610
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,271,183,688 1,454,050,830
21 Total liabilities (Part X, line 26)............. 696,328,840 1,104,155,026
22 Net assets or fund balances. Subtract line 21 from line 20..... 574,854,848 349,895,804
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid preparer use only
Print/type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image
Firm's address Right pointing arrowhead image



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2011)
Form 990 (2011)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III .........
1
Briefly describe the organization’s mission: TO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 2,572,231,184 including grants of $ 5,524,099 ) (Revenue $ 2,834,660,196 )
member health care services and medical training for care improvement- Kaiser Foundation Health Plan of Colorado (KFHP of Colorado) 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 Colorado educates and trains medical students and other health care professionals and promotes scientific and nursing education in order to improve care. Additional information about Colorado Health Plan's charitable activities can be found in Schedule O, Community Benefit Report.
4b (Code:   ) (Expenses $ 19,505,848 including grants of $ 0 ) (Revenue $ 245,395 )
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 5,215 patients, providing 6,759 prescriptions and 11,600 outpatient office visits. CHC - these programs are available to low income adults and children who are not eligible for other public or privately sponsored coverage. More than 460 patients received comprehensive care for up to two years through this program.
4c (Code:   ) (Expenses $ 46,678,922 including grants of $ 0 ) (Revenue $ 15,632,654 )
Medicaid and Other Government Sponsored Programs Health Plan is committed to improving the way Medicaid beneficiaries receive care, not only in our facilities, but also in the communities we serve. As part of the State of Colorado Medicaid Program's Primary Care Physician Program, Colorado Health Plan provides primary and specialty care to Medicaid beneficiaries. In 2011, the Colorado Health Plan provided care and services to 11,441 beneficiaries. Colorado Health Plan also participates in the State Child Health Insurance Program (CHP+), serving 5,229 beneficiaries in a fully capitated HMO arrangement.
(Code:   ) (Expenses $ 16,454,863 including grants of $ 281,501 ) (Revenue $ 0 )
SCH. O, COMMUNITY BENEFIT REPORT
4d Other program services (Describe in Schedule O.)
(Expenses $ 16,454,863 including grants of $ 281,501 ) (Revenue $ 0 )
4e Total program service expensesMediumBullet$ 2,654,870,817
Form 990 (2011)
Form 990 (2011)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II
Click to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part IClick to see attachment....................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment
...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IV
Click to see attachment
...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
 
No
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
Yes
 
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H.....
20a
 
No
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statement to this return? Note. All Form 990 filers that operated one or more hospitals must attach audited financial statements.
20b
 
 
Form 990 (2011)
Form 990 (2011)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
Yes
 
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I......
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II
.........................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV
...................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV..
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I
...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2011)
Form 990 (2011)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V .........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
4,799
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
6,093
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2011)
Form 990 (2011)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI .........
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
If the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
1a
14
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
12
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? .................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ............
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ..........
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? ....
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done ....................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes," to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
CO
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
VP - NATIONAL TAX COMPLIANCE
ONE KAISER PLAZA 15L
OAKLAND,CA94612
(510) 271-6385
Form 990 (2011)
Form 990 (2011)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII .........
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (describe hours for related organizations in Schedule O)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) Christine Cassel
Director
.5 X           0 184,500 0
(2) Thomas Chapman
Director
1.0 X           0 180,695 89,109
(3) Daniel P garcia
SVP, Chief Compliance Officer
2.0 X   X         1,228,765 73,604
(4) William Graber
Director
1.0 X           0 208,269 0
(5) Eugene Grisby III
Director
1.0 X           0 199,900 0
(6) George C Halvorson
Chairman and CEO
5.0 X   X         7,861,915 74,595
(7) Judith Johansen
Director
.5 X           0 200,075 0
(8) Kim J Kaiser
Director
.5 X           0 124,500 0
(9) Philip Marineau
Director
.5 X           0 200,769 0
(10) Jenny Ming
Director
.3 X           0 179,269 0
(11) Edward Pei
Director
.5 X           0 173,000 16,500
(12) J Neal Purcell
Director
.5 X           0 221,858 0
(13) Cynthia Telles
Director
.5 X           0 195,613 0
(14) meg porfido
director
.5 X           0 35,013 0
(15) Sandra Thompkins
Director
.5 X           0 39,031 0
(16) Mitchell SCohen
Region Liaison
30.0     X         254,808 37,746
(17) Kathryn Lancaster
EVP & CFO
4.0     X         2,109,102 289,626
Form 990 (2011)
Form 990 (2011)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (describe hours for related organizations in Schedule O)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) Donna Lynne
Region President Colorado
18.0     X         1,314,917 222,947
(19) Thomas R Meier
SVP, Corporate Treasurer
3.0     X         802,247 110,802
(20) Donald H Orndoff
SVP, NFS
5.0     X         634,274 137,999
(21) ROCHELLE M Roth
SENIOR DIRECTOR,QRM
5.0     X         196,984 42,093
(22) Arthur M Southam
EVP, Health Plan Operations
5.0     X         2,649,224 348,687
(23) Deborah Stokes
SVP, Controller & Chief Accoun
4.0     X         720,302 118,018
(24) Bernard J Tyson
President & COO
5.0     X         2,800,296 482,152
(25) Victoria B Zatkin
VP, Off of Brd & Corp Gov Svcs
4.0     X         314,768 84,531
(26) Mark S Zemelman
SVP, Gen Counsel & Secretary
3.0     X         778,576 191,923
(27) Keith J Evans
VP, MSBD - CO
30.0       X     0 379,041 53,267
(28) Jeffrey L Hahn
Dir Sales & Acct Mgt
30.0       X       327,093 39,261
(29) Anne E McDow
VP, Health Plan Admin - CO
30.0       X       457,575 94,167
(30) James Newsome
VP, CFO - CO
30.0       X       523,344 102,194
(31) Elizabeth M Reimann
Area Administrator
50.0       X     158,348   38,721
(32) Nancy L Wollen
SVP, Operations
30.0       X       402,062 94,288
(33) Jean L Barker
Market & Prod Strategy Dir
30.0         X   346,596 0 65,348
(34) Richard Roland Lyon
VP, Region Strategy Performanc
30.0         X     386,069 73,300
(35) Virginia M McLain
VP, Primary Care & Med Special
30.0         X     360,934 109,985
(36) Robin Sadler
VP, HR - Colorado
30.0         X     319,249 89,989
(37) John K Warren
Sr Sales Director
30.0         X     379,196 35,047
(38) Steven R Zatkin
consultant
0.0           X   574,121 76,925
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 504,944 27,917,354 3,192,824
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet955
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
COLORADO PERMANENTE MEDICAL GROUP
10350 E DAKOTA AVE
DENVER,CO80231
MEDICAL SERVICES 449,089,436
SAINT JOSEPH HOSPITAL
1835 FRANKLIN STREET
DENVER,CO80218
MEDICAL SERVICES 396,430,784
PSL Medical Center
PO Box 403838
ATLANTA,GA30384
medical services 101,200,381
EXEMPLA INC
8300 W 38TH AVENUE
WHEAT RIDGE,CO80033
medical services 62,228,282
CATHOLIC HEALTH INITIATIVES CO
360 PEAK ONE DRIVE SUITE 390
FRISCO,CO80045
medical services 54,734,795
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet488
Form 990 (2011)
Form 990 (2011)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 12,858,312
e Government grants (contributions)1e 645,684
f All other contributions, gifts, grants, and
similar amounts not included above
1f
1,045,688
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 14,549,684
 Program Service Revenue Business Code
2a MEMBERS HEALTH DUES 621,400 1,916,670,930 1,916,670,930    
b SUPPL CHARGE/PHARM 621,400 149,108,603 149,108,603    
c NON-PLAN & INDUSTRIAL 621,400 2,697,421 2,357,781 339,640  
d OTHER PROGRAM SERV 621,400 42,326,142 42,326,142    
e MEDICARE 621,400 740,074,789 740,074,789    
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 2,850,877,885
 Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 22,374,867     22,374,867
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 31,381  
b Less: rental expenses    
c Rental income or (loss) 31,381  
d Net rental income or (loss).......MediumBullet 31,381     31,381
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 382,677,265 181,971
b Less: cost or other basis and sales expenses 378,590,171 597,654
c Gain or (loss) 4,087,094 -415,683
d Net gain or (loss)..........MediumBullet 3,671,411     3,671,411
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 0
12 Total revenue. See Instructions....MediumBullet 2,891,505,228 2,850,538,245 339,640 26,077,659
Form 990 (2011)
Form 990 (2011)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Check if Schedule O contains a response to any question in this Part IX. .........
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 5,775,900 5,775,900
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 29,700 29,700
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 .... 609,013   609,013  
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 403,281,268 363,661,659 39,619,609 0
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 53,435,273 53,435,273    
9 Other employee benefits ....... 119,960,334 102,048,858 17,911,476  
10 Payroll taxes ........... 30,038,453 30,033,279 5,174  
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 280,868   280,868  
c Accounting ........... 1,226,891   1,226,891  
d Lobbying ........... 299,944   299,944  
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 621,447 621,447    
g Other .......... 0      
12 Advertising and promotion .... 33,475,581 1,047,948 32,427,633  
13 Office expenses ....... 8,316,542 7,227,547 1,088,995  
14 Information technology ...... 139,695,857 121,385,810 18,310,047  
15 Royalties .. 0      
16 Occupancy ........... 12,666,273 12,666,273    
17 Travel ............ 3,066,582 2,597,339 469,243  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 746,479   746,479  
20 Interest ........... 0      
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 38,899,153 38,899,153    
23 Insurance .............. 9,090,704 9,090,704    
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 BASIC CONTRACT PAYMENTS 1,003,998,248 1,003,998,248    
b PURCHASED MED SVC- OUTSIDE 486,531,982 486,295,731 236,251  
c SUPPLIES 299,962,899 281,419,947 18,542,952  
d INTER-REGIONAL CHARGES 67,599,161 63,371,872 4,227,289  
e
f All other expenses 118,390,066 71,264,129 47,125,937  
25 Total functional expenses. Add lines 1 through 24f 2,837,998,618 2,654,870,817 183,127,801 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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2011)
Form 990 (2011)
Page 11
Part X Balance Sheet
(A)
Beginning of year
(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 23,591,535 1 5,290,515
2 Savings and temporary cash investments ....... 0 2 0
3 Pledges and grants receivable, net ......... 0 3 0
4 Accounts receivable, net ......... 67,595,528 4 96,053,815
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 .............. 23,924,527 8 26,196,168
9 Prepaid expenses and deferred charges ............ 3,189,515 9 23,361,803
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 707,226,686
b Less: accumulated depreciation. ..... 10b 367,784,182 326,224,552 10c 339,442,504
11 Investments—publicly traded securities .......... 703,807,021 11 925,177,783
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 ........... 122,851,010 15 38,528,242
16 Total assets. Add lines 1 through 15 (must equal line 34)... 1,271,183,688 16 1,454,050,830
Liabilities 17 Accounts payable and accrued expenses . 197,591,391 17 398,532,876
18 Grants payable .......... 0 18 0
19 Deferred revenue .......... 31,416,374 19 26,234,276
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..... 467,321,075 25 679,387,874
26 Total liabilities. Add lines 17 through 25..... 696,328,840 26 1,104,155,026
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .....   27  
28 Temporarily restricted net assets .....   28  
29 Permanently restricted net assets .....   29  
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ..... 2,510 30 2,410
31 Paid-in or capital surplus, or land, building or equipment fund ..... 0 31 0
32 Retained earnings, endowment, accumulated income, or other funds 574,852,338 32 349,893,394
33 Total net assets or fund balances ..... 574,854,848 33 349,895,804
34 Total liabilities and net assets/fund balances ..... 1,271,183,688 34 1,454,050,830
Form 990 (2011)
Form 990 (2011)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI .........
1
Total revenue (must equal Part VIII, column (A), line 12) ...
1
2,891,505,228
2
Total expenses (must equal Part IX, column (A), line 25) ....
2
2,837,998,618
3
Revenue less expenses. Subtract line 2 from line 1 ...
3
53,506,610
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
574,854,848
5
Other changes in net assets or fund balances (explain in Schedule O) ...
5
-278,465,654
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) ....
6
349,895,804
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII .........
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?....
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. ...........................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
Yes
 
Form 990 (2011)
Additional Data


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

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

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
KAISER FDN HEALTH PLAN OF COLORADO
 
Employer identification number

84-0591617
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization
(ii)
EIN
(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv)
Is the organization in col. (i) listed in your governing document?
(v)
Did you notify the organization in col. (i) of your support?
(vi)
Is the organization in col. (i) organized in the U.S.?
(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2011
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).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2011
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.") . 11,527,857 9,807,549 8,613,103 10,958,451 14,549,684 55,456,644
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... 2,160,542,030 2,271,435,768 2,340,697,699 2,587,673,738 2,850,877,885 12,211,227,120
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5. 2,172,069,887 2,281,243,317 2,349,310,802 2,598,632,189 2,865,427,569 12,266,683,764
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)           12,266,683,764
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... 2,172,069,887 2,281,243,317 2,349,310,802 2,598,632,189 2,865,427,569 12,266,683,764
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. 9,408,477 29,515,635 26,091,143 22,888,156 22,406,248 110,309,659
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b. 9,408,477 29,515,635 26,091,143 22,888,156 22,406,248 110,309,659
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.). 2,181,478,364 2,310,758,952 2,375,401,945 2,621,520,345 2,887,833,817 12,376,993,423
14
Section C. Computation of Public Support Percentage
15
15
99.109 %
16
16
99.159 %
Section D. Computation of Investment Income Percentage
17
17
0.891 %
18
18
0.841 %
19a
b
20
Schedule A (Form 990 or 990-EZ) 2011
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:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2011
Name of organization
KAISER FDN HEALTH PLAN OF COLORADO
 
Employer identification number

84-0591617
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box 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
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
KAISER FDN HEALTH PLAN OF COLORADO
 
Employer identification number

84-0591617
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




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
KAISER FDN HEALTH PLAN OF COLORADO
 
Employer identification number

84-0591617
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 COLORADO
 
Employer identification number

84-0591617
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
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Additional Data


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

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

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
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 COLORADO
 
Employer identification number

84-0591617
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

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

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

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










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2011

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

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in)
(a) 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


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
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
240,619
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
Yes
 
0
i
Other activities? ..........................
Yes
 
59,325
j
Total. Add lines 1c through 1i ...............................
299,944
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) 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”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, Part II-A; line 5; and Part ll-B, line 1.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
LOBBYING ACTIVITY BY NONELECTING PUBLIC CHARITIES SCHEDULE C, PART II-B, LINE 1A THROUGH 1I 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:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 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 COLORADO
 
Employer identification number

84-0591617
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds 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? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a 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.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (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.
b
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 $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958), relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance ....        
b Contributions ........        
c 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 ......        
2
Provide the estimated percentage of the year end balance (line 1g) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   39,087,562 39,087,562
b Buildings ................   405,115,344 195,732,600 209,382,744
c Leasehold improvements ............   22,114,231 12,747,992 9,366,239
d Equipment ................   189,557,380 136,821,396 52,735,984
e Other .................   51,352,169 22,482,194 28,869,975
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 339,442,504
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








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








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








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Book value
Federal Income Taxes 0
RESERVE FOR WORKERS COMP RISKS 4,966,734
OTHER LIABILITIES 30,445,751
PROF & PUBLIC LIABILITIES 43,751,450
POST RETIREMENT LIABILITIES 600,223,939





Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 679,387,874
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

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 2,891,505,228
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 2,837,998,618
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 53,506,610
4 Net unrealized gains (losses) on investments .......................... 4 10,456,211
5 Donated services and use of facilities ............................. 5 0
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV.) ................................. 8 -288,921,864
9 Total adjustments (net). Add lines 4 through 8 ......................... 9 -278,465,653
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 -224,959,043
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 2,899,010,291
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a 10,456,211
b Donated services and use of facilities ......... 2b 0
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV.) ............ 2d 538,292
e Add lines 2a through 2d ..................... 2e 10,994,503
3 Subtract line 2e from line 1..................... 3 2,888,015,788
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 3,489,440
c Add lines 4a and 4b....................... 4c 3,489,440
5 Total Revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 2,891,505,228
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 3,123,969,234
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 290,868,986
e Add lines 2a through 2d...................... 2e 290,868,986
3 Subtract line 2e from line 1..................... 3 2,833,100,248
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 621,447
b Other (Describe in Part XIV.) ............ 4b 4,276,923
c Add lines 4a and 4b....................... 4c 4,898,370
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 2,837,998,618
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 LINE 8: DECREASE IN OTHER COMPREHENSIVE INCOME <104,176,778> GAIN/LOSS ON INVESTMENTS - TAX < 4,087,094> GAIN/LOSS ON INVESTMENTS - BOOK 6,313,213 CHANGE IN CAPITAL STOCK < 100> SEE "NOTE 1" < 6,478,675> EQUITY TRANSFER TO KF HOSPITALS < 180,492,431> _____________ TOTAL <288,921,864> 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: BAD DEBT EXPENSES - RECLASS <$4,276,923> GAIN/LOSS ON INVESTMENTS - BOOK 6,313,213 INTER-ENTITY REVENUE - RECLASS 5,602,124 investment management fees - reclass <621,447> OTTI < 6,478,675> TOTAL $ 538,292 LINE4B: FIXED ASSETS LOSS - RECLASS <$ 597,654> GAIN/LOSS ON INVESTMENTS - TAX 4,087,094 TOTAL $3,489,440
Schedule D, Part XIII Reconciliation of Expenses LINE 2D: FIXED ASSET LOSS - RECLASS $ 597,654 INTER-ENTITY REVENUE - RECLASS 5,602,124 DECREASE IN OTHER COMPREHENSIVE INCOME 104,176,777 EQUITY TRANSFER TO KF HOSPITALS 180,492,431 Total $290,868,986 Line 4a: investment management fees - reclass $ 621,447 LINE 4b: BAD DEBT EXPENSES - RECLASS $ 4,276,923
Schedule D (Form 990) 2011

Additional Data


Software ID:  
Software Version:  




Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
KAISER FDN HEALTH PLAN OF COLORADO
 
Employer identification number
84-0591617
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed
......................... lBullet
(a) Name and address of organization
or government
(b) EIN (c) IRC Code section
if applicable
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
non-cash assistance
(h) Purpose of grant
or assistance
(1) Childrens Hospital Fnd13123 E16th Ave Box 080
Aurora,CO80045
84-0813462 501(c)(3) 5,200       Burn Center
(2) Denver FND55 Madison St 8th FL
Denver,CO80206
84-6048381 501(c)(3) 5,517,500       Donor Contribution
(3) Exempla Good Sam Med Ctr FND200 Exempla Circle
Lafayette,CO80026
84-1649162 501(c)(3) 8,000       Cardiac Care
(4) Juv Diabetes Research FND Int'l120 Wall St 19th FL
New York,NY10005
23-1907729 501(c)(3) 10,000       Cure for Diabetes
(5) Metro Denver Black Church Init3601 Martin Luther King Blvd
Denver,CO80205
84-1477546 501(c)(3) 7,000       Diabetes Training
(6) Nat'l Multiple Sclerosis Society900 So Broadway 250
Denver,CO80209
84-0412595 501(c)(3) 5,675       gift matching
(7) St Joseph Hospital FND1835 Franklin St
Denver,CO80218
84-0735096 501(c)(3) 15,000       Medi Care Program
(8) Univ of CO FND IncCampus Box 142 PO Box 173364
Denver,CO80217
84-6049811 501(c)(3) 10,000       Ctr on Domestic Viol








2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
8
3
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

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
(1) Scholarships 6 29,700   cash amount  













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. Larger grants (typically over $100K) may require quarterly progress reports.
Schedule I (Form 990) 2011


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
KAISER FDN HEALTH PLAN OF COLORADO
 
Employer identification number

84-0591617
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. 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.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2011

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
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) Jean L Barker (i)
(ii)
192,892
0
143,826
0
9,878
0
50,691
0
14,657
 
411,944
0
 
 
(2) Christine Cassel (i)
(ii)
0
184,500
0
0
0
0
0
0
0
0
0
184,500
0
0
(3) Thomas Chapman (i)
(ii)
0
180,695
0
0
0
0
0
89,109
0
0
0
269,804
0
0
(4) Mitchell SCohen (i)
(ii)
 
124,146
 
111,800
 
18,862
0
27,875
0
9,871
0
292,554
0
 
(5) Keith J Evans (i)
(ii)
0
226,160
0
 
0
152,881
0
39,889
0
13,378
0
432,308
0
 
(6) Daniel P garcia (i)
(ii)
 
562,551
 
640,000
 
26,214
0
61,308
0
12,296
0
1,302,369
0
 
(7) William Graber (i)
(ii)
0
208,269
0
0
0
0
0
0
0
0
0
208,269
0
0
(8) Eugene Grisby III (i)
(ii)
0
199,900
0
0
0
0
0
0
0
0
0
199,900
0
0
(9) Jeffrey L Hahn (i)
(ii)
 
132,820
 
186,714
 
7,559
0
24,604
0
14,657
0
366,354
0
 
(10) George C Halvorson (i)
(ii)
 
1,215,613
 
5,039,506
 
1,606,796
 
61,308
 
13,287
 
7,936,510
 
0
(11) Judith Johansen (i)
(ii)
0
200,075
0
0
0
0
0
0
0
0
0
200,075
0
0
(12) Kathryn Lancaster (i)
(ii)
 
630,520
 
907,953
 
570,629
 
276,632
 
12,994
 
2,398,728
 
529,003
(13) Donna Lynne (i)
(ii)
 
476,108
 
475,000
 
363,809
 
208,108
 
14,839
 
1,537,864
 
323,554
(14) Richard Roland Lyon (i)
(ii)
 
222,719
 
112,268
 
51,082
 
58,461
 
14,839
 
459,369
 
35,673
(15) Philip Marineau (i)
(ii)
0
200,769
0
0
0
0
0
0
0
0
0
200,769
0
0
(16) Anne E McDow (i)
(ii)
 
212,491
 
134,990
 
110,094
 
79,328
 
14,839
 
551,742
 
75,590
(17) Virginia M McLain (i)
(ii)
 
205,645
 
121,169
 
34,120
 
95,146
 
14,839
 
470,919
 
 
(18) Thomas R Meier (i)
(ii)
 
314,471
 
339,188
 
148,588
 
97,808
 
12,994
 
913,049
 
113,944
(19) Jenny Ming (i)
(ii)
0
179,269
0
0
0
0
0
0
0
0
0
179,269
0
0
(20) James Newsome (i)
(ii)
 
269,523
 
137,940
 
115,881
 
86,806
 
15,388
 
625,538
 
81,215
(21) Donald H Orndoff (i)
(ii)
 
376,297
 
235,328
 
22,649
 
124,482
 
13,517
 
772,273
 
 
(22) Edward Pei (i)
(ii)
0
173,000
0
0
0
0
0
16,500
0
0
0
189,500
0
0
(23) J Neal Purcell (i)
(ii)
0
221,858
0
0
0
0
0
0
0
0
0
221,858
0
0
(24) Elizabeth M Reimann (i)
(ii)
124,522
 
21,312
 
12,514
 
23,882
 
14,839
 
197,069
 
 
 
(25) ROCHELLE M Roth (i)
(ii)
 
167,206
 
26,934
 
2,844
 
29,508
 
12,585
 
239,077
 
 
(26) Robin Sadler (i)
(ii)
 
189,208
 
98,438
 
31,603
 
74,601
 
15,388
 
409,238
 
 
(27) Arthur M Southam (i)
(ii)
 
741,374
 
1,175,000
 
732,850
 
336,623
 
12,064
 
2,997,911
 
688,121
(28) Deborah Stokes (i)
(ii)
 
315,132
 
337,575
 
67,595
 
105,024
 
12,994
 
838,320
 
48,521
(29) Cynthia Telles (i)
(ii)
0
195,613
0
0
0
0
0
0
0
0
0
195,613
0
0
(30) Bernard J Tyson (i)
(ii)
 
892,605
 
1,290,000
 
617,691
 
469,158
 
12,994
 
3,282,448
 
587,707
(31) John K Warren (i)
(ii)
 
184,088
 
188,765
 
6,343
 
20,208
 
14,839
 
414,243
 
 
(32) Nancy L Wollen (i)
(ii)
 
253,281
 
131,679
 
17,102
 
79,449
 
14,839
 
496,350
 
 
(33) Steven R Zatkin (i)
(ii)
 
4,500
 
542,685
 
26,936
 
66,393
 
10,532
 
651,046
 
 
(34) Victoria B Zatkin (i)
(ii)
 
192,675
 
85,692
 
36,401
 
82,570
 
1,961
 
399,299
 
 
(35) Mark S Zemelman (i)
(ii)
 
398,502
 
259,500
 
120,574
 
179,338
 
12,585
 
970,499
 
80,051
Schedule J (Form 990) 2011

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   Steven Zatkin- General Counsel to 6/30/10; consultant 3/4/11 to present. Sandra Thompkins- board of directors to 4/1/11. SCHEDULE J, PART I, LINE 3 Top Management Officials' Compensation Kaiser Foundation Health Plan of Colorado 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 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN GEORGE HALVORSON 1,500,000 KATHRYN LANCASTER 529,350 DONNA LYNNE 323,554 RICHARD R LYON 35,673 ANNE E MCDOW 75,590 THOMAS MEIER 114,428 JAMES NEWSOME 81,215 ARTHUR M SOUTHam 688,121 DEBORAH STOKES 48,521 BERNARD J TYSON 587,707 STEVEN ZATKIN 4,891 MARK ZEMELMAN 81,133 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   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:  
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 COLORADO
 
Employer identification number

84-0591617
Identifier Return Reference Explanation
Form 990, Part I, Line 7b Net Unrelated Business Taxable Income from Form 990-T, Line 34 TOTAL UBI (FORM 990-T, LINE 30) $28,216 NET OPERATING LOSS (NOL) APPLIED <$28,216> __________ UBTI WITH NOL (FORM 990-T, LINE 34) NONE
Form 990, Part VI, Line 4 Changes to governing documents On March 3, 2011, Article E., Officers, of the Bylaws of the Corporation was amended 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); (d) provide clarification regarding leadership in the event of the absence or disability of the President (Section E-9, Executive or National Senior Vice President); and (e) change the reference to "the President" in Sections E-3, E-4 and E-11 to "any President". On June 23, 2011, minor technical amendments were made to the Bylaws of the Corporation to make them more consistent with the Bylaws of Kaiser Foundation Health Plan, Inc. and its Health Plan subsidiaries and with organizational policies and current law. None of the changes were significant; and On December 1, 2011, Article A, Purpose, of the Bylaws of the Corporation was amended to (a) more clearly state the purposes in one Purpose section (A-1, former section A-2 was deleted); (b) expressly state that the corporation is prohibited from engaging in activities not permitted by Section 501(c)(3) of the Internal Revenue Code and to specifically state that the corporation shall not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office (Section A-3 Nonprofit Character - now A-2); (c) make a reference to the Internal Revenue Code consistent with other references in the Bylaws (Section A-4 Disposition of Assets on Liquidation or Dissolution - now A-3); and (d) be consistent with current legal standards (Section A-5 Non-discrimination - now A-4).
Form 990, Part VI, 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 (KFHP) appoints the Directors (and fills vacancies and has authority to remove Directors). The same 14 individuals who comprise the Board of Directors of KFHP also serve as the 14 Directors of KFHP Colorado, Ohio, Northwest and Mid-Atlantic States.
Form 990, Part VI, Line 7b Member's approval The following actions of the corporation require approval of the sole member: a. removal of the Chairman of the Board or the Regional President; b. amendment of Article D, Section D-4 of the Bylaws - Election and Term of Office of Directors
Form 990, Part VI, Line 11b Review process 1. Key information necessary for the preparation of the tax return is obtained and/or confirmed with internal sources including regional finance, executive compensation, community benefits, treasury, government relations, and legal. 2. Community benefits details are presented to the community benefit committee of the board for review. 3. Executive compensation details are presented to the compensation committee of the board for review. 4. The complete tax return is reviewed and signed by a PRICEWATERHOUSECOOPERs LLC tax advisor. 5. The complete tax return is reviewed and signed by an officer or a member of management designated by an officer. 6. The tax return is discussed with the full board of directors. A copy of the return is provided to each board member in electronic format prior to filing.
Form 990, Part VI, 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 LLP 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 LLP and is available upon request. To request copies contact: Vice President - 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 organization 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 Capital Stock <$ 100> Change in Unrealized Gain (Loss) 10,456,211 Change in Other Comprehensive Inc. <104,176,778> Gain/Loss on Investments - Tax < 4,087,094> Gain/Loss on Investments - Book 6,313,213 OTTI Loss < 6,478,675> Equity Transfer to KF Hospitals <180,492,431> ______________ Total Other Changes in Net Assets <$278,465,654>
Form 990, Part III, Line 4a-d Exempt purpose achievements - Program services 2011 COMMUNITY BENEFIT REPORT KAISER FOUNDATION HEALTH PLAN OF COLORADO Kaiser Foundation Health Plan of Colorado or "Colorado Health Plan" is a tax-exempt subsidiary health plan of Kaiser Foundation Health Plan, Inc. (KFHP). Colorado Health Plan, as well as Kaiser Foundation Hospitals (KFH) are nonprofit corporations that are part of the integrated health care delivery system known as the Kaiser Permanente Medical Care Program or "Kaiser Permanente." In 2011, Colorado Health Plan served 532,801 members and has more than 5,378 full-time administrative, clerical and technical employees. Colorado Health Plan provides and arranges comprehensive health care services for members on a predominantly prepaid basis and fulfills its contractual obligations to group and individual members by contracting with KFH, and a Permanente Medical Group to provide 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, occupational status, or income level. Health Plan members are broadly representative of the various ages, social, and income groups within the areas served. Once enrolled, a member is free to maintain membership regardless of age, health status, or employment. KAISER PERMANENTE'S COMMITMENT TO THE COMMUNITY Kaiser Permanente believes its Direct Community Benefit Investment (DCBI), is fundamental to being a nonprofit organization. It embodies the organization's commitment to improve the health of communities beyond services to Health Plan members. It is more than traditional corporate citizenship or corporate philanthropy. It is an intentional, planned, budgeted, measurable, accountable creation for better health in our communities. It is done in collaboration with, not in isolation from, the community. DCBI serves to fulfill Kaiser Permanente's social purpose, justify its tax-exempt status, and differentiate it from other health care organizations. This tradition of community benefit dates from the earliest days of the Program, when charitable care to non-employees, and later, nonmembers, was initiated. That heritage has continued through the years in Kaiser Permanente's early participation in publicly financed programs such as Medicaid and Medicare, establishment of residency training and medical research programs, and later, in the development of the Educational Theatre Programs, Safety Net Partnerships, Community Health Initiatives and the Charitable Health Coverage Program. 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 (CHI) - Seeks to measurably improve the health of the communities we serve. CHI takes Kaiser Permanente beyond the doctor's office to ensure the healthy choice is an easy choice in schools, neighborhoods, workplaces, and health care settings. Through funding, technical expertise and community engagement, we invest in prevention and evidence-based practices. Our public health interventions, community activism, and environmental and policy work are designed to transform community conditions that influence health. Our Healthy Eating Active Living focus is advanced through additional investments in: Active Transportation, Schools, Healthy Eating in Hard Times, and Community to Clinic Integration. - Safety Net Partnerships - Builds partnerships with community clinics, local health departments, and public hospitals. Provides funding, technical assistance, dissemination of care management and quality improvements technology to help improve care and expand treatment capacity for vulnerable populations. - Developing and Disseminating Knowledge - Improves health care by sharing our knowledge- educating practitioners, advancing research, empowering consumers and informing policymakers about the evidence base for care and health. The Board elaborated that at least 75% of total community benefit funding will be directed to program priorities within the four streams of work and the remaining 25% of funding will be directed by local regions to respond to local community benefit needs and opportunities that may or may not be within the four priority areas. THE COMMUNITY BENEFIT PROGRAM IN THE COLORADO REGION In 2011, Colorado Health Plan expended $88.7 million to support community benefit activities. A breakdown of the 2011 Community Benefit dollars attributable to the Health Plan in Colorado 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 the Health Plan of Colorado. 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 Colorado Health Plan expended $52 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 KP facility or by a KP provider. Charitable Care (Medical Financial Assistance and Charitable Health Coverage) In the Colorado Region, Health Plan provides charity care to low-income vulnerable populations through two programs: Medical Financial Assistance and their charitable health coverage program - KPSTEP. In 2011, the Colorado Health Plan Region spent approximately $19.3 million making high quality health care affordable for low income residents in the region. - Medical Financial Assistance Program This program assists patients in need by subsidizing all or a portion of the Kaiser Permanent medical expenses. Eligibility is based on prescribed level of income, expenses and assets. This charity care program also includes discounted charges for uninsured patients below 400% of the federal poverty guidelines and contracted collection agency practices which align with Kaiser Permanente social values. In 2011, 5,253 patients benefited from the program. In addition, charity care is also provided through one of our partner hospitals (Exempla). KP physicians provide care in the emergency room, in surgery settings, as rounding hospitalists, and in various other medical settings on the Exempla campus. Any additional follow-up care is provided in Colorado Health Plan's medical offices. - KPStep Charitable Health Coverage (CHC) is a unique approach to caring for low-income uninsured persons in the community. Participants receive a regular Kaiser Permanente membership card and access to the full range of our service and providers-a much better alternative to a brief and costly emergency room visit or hospitalization. This allows us to invest in the longer term health of patients and the community. Since inception in the early 1980s, CHC programs have made a real difference in the lives of persons who might otherwise have no other source of care. In Colorado, KPStep is a charitable health coverage program that allows uninsured low-income patients access to health care via a subsidized insurance product. The program offers a 24 month membership with rich benefits, subsidized premiums and low co-payments. Participants must qualify by income and asset standards, and can not be eligible for any other government sponsored health care program or private group health care coverage. Based on income, the plan subsidizes up to 95% of their premium. Referrals to KPStep come from community partners and from Colorado Health Plan members losing their coverage.
Participation in Medicaid and Other Government-Sponsored Programs   The Colorado Health Plan provided coverage and services valued at $31 million (in excess of reimbursement) for individuals in government-sponsored programs. - Medicaid - As part of the State of Colorado Medicaid Program's Primary Care Physician Program, Colorado Health Plan provides primary and specialty care to Medicaid beneficiaries that select Kaiser Permanente as their primary care provider. Beneficiaries have access to both primary and specialty care in Health Plan facilities, as well as pharmacy and durable medical equipment benefits. Health Plan submits charges to the state for payment on a fee-for-service basis. Additional outside services provided are billed directly to the state. In 2011, Colorado Health Plan provided care and services to more than 11,441 beneficiaries. - Child Health Plan Plus (CHP+) - Colorado Health Plan participates in this program, serving 5,229 beneficiaries in a fully capitated HMO arrangement. CHP+ serves children under age 19. Eligibility includes proof of US citizenship or permanent residency, ineligibility for Medicaid or Medicare and lack of access to employer-sponsored insurance. COMMUNITY HEALTH INITIAVITES 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 Colorado Health Plan spent $641,086 on community health initiatives during 2011. Community Health Education and Prevention Programs The Colorado Health Plan provides a variety of health education classes, events and programs for the general public. The health education department staffed booths at local health fairs, conducted smoking cessation, weight loss, parenting classes, and hosted a series of seminars on health-related topics, such as diabetes, stress management, and managing chronic illness. Expenditures in this category exclude program cost for health education programs targeting or restricted to Health Plan members. Grants and Donations for Community Health Initiatives While Colorado is among the leanest states, with 41.5 percent of adults being at a healthy weight, the prevalence of overweight and obesity in the state is rising in concert with national rates, putting a large portion of the population at risk for cardiovascular disease, diabetes, cancer, hypertension and asthma. In addition, the health-related economic cost of obesity to Americans is substantial - over $900 million annually in Colorado. Colorado has the second fastest increasing rate of child obesity ranking 23rd nationally. Kaiser Health Plan of Colorado, (KPCO) is a co-founder of LiveWell Colorado, a statewide non-profit organization, dedicated to obesity prevention, multi-sector policy efforts, social marketing and 22 coalition-based community initiatives. Since 2006, over 800,000 Colorado residents have been reached by LiveWell community strategies. Over 1,550 partners representing schools, health agencies, healthcare organizations, senior services and local businesses have adopted LiveWell strategies. To date, the LiveWell Colorado Community Initiative has invested in the following strategies: - Comprehensive community coalition building - Increasing active living through community walk ability and bike ability - Creating access to fresh, affordable and health food - Promoting worksite wellness - Promoting healthy schools - Working with healthcare settings to increase breastfeeding hospital practices and build provider skills in weight management 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 Colorado Health Plan's Safety Net initiative develops partnerships with existing community health clinics and organizations that provide low-cost or free medical resources for low-income patients in efforts to support their ability to provide quality health care to the medically underserved populations of Colorado. Through various program elements, KPCO enable its Safety Net partners to provide increased access to health care, improved quality of care to its patients, and helps to build the capacity of the Safety Net clinics and organizations. The goal of this Community Benefit initiative is to work toward achieving Kaiser Permanente's mission to improve the health status of the community in which we serve. A significant part of our Safety Net program is through knowledge translation (including education) and grant making of strategic initiatives to fill existing gaps in the community clinic system. DEVELOPING AND DISSEMINATING KNOWLEDGE kaiser Permanente aims to improve health care by sharing its knowledge, educating practitioners, advancing research, empowering consumers, and informing policymakers about the evidence base for care and health. The Colorado Health Plan spent $34.5 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 In 2011, the Colorado Health Plan spent approximately $21.5 million to support Community Benefit focused clinical and health services research. Many of the research studies address current health issues and improve care for common conditions where treatment often is linked to community-based efforts, and are broadly disseminated through articles and professional presentations. The Kaiser Permanente Colorado Institute for Health Research (IHR) publishes and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and the communities we serve. IHR has a specific focus on conducting research that can be translated into clinical practice, health promotion, and policies to influence the health of individuals and populations. Currently, the IHR's 120-plus staff is working on more than 160 epidemiological and health services research projects. Now in its 16th year of operation, the IHR is responsible for many landmark findings. Teams of investigators continue to collaborate on major research projects with national partners including the Centers for Disease Control and Prevention Vaccine Safety Datalink, and federally funded research networks in cardiovascular disease, cancer, and medication use and safety. In 2011, IHR published approximately 90 studies in peer-reviewed journals. Following are a few examples of those studies: - Magid DJ, Ho PM, Olson KL, Brand DW, Welch LK, Snow KE, Lambert-Kerzner AC, Plomondon ME, Havranek EP. A Multimodal Blood Pressure Control Intervention in 3 Healthcare Systems. Am J Manag Care. 2011 Apr 1;17(4):e96-e103. PMID: 21657813 OBJECTIVE: To determine if a multimodal intervention composed of patient education, home blood pressure (BP) monitoring, BP measurement reporting to an interactive voice response (IVR) phone system, and clinical pharmacist follow-up improves BP control compared with usual care. STUDY DESIGN: Prospective study with patient enrollment, medication consultation and adjustment, remote BP monitoring, and follow-up at 6 months. METHODS: This randomized controlled trial was conducted at 3 healthcare systems in Denver, Colorado, including a large health maintenance organization, a Veterans Affairs medical center, and a county hospital. At each site, patients with uncontrolled BP were randomized to the multimodal intervention vs usual care for 6 months, with the primary end point of BP reduction. RESULTS: Of 338 patients randomized, 283 (84%) completed the study, including 138 intervention patients and 145 usual care patients. Baseline BP was higher in the intervention group vs the usual care group (150.5/89.4 vs 143.8/85.3 mm Hg). At 6 months, BPs were similar in the intervention group vs the usual care group (137.4 vs 136.7 mm Hg, P = .85 for systolic; 82.9 vs 81.1 mm Hg, P = .14 for diastolic). However, BP reductions were greater in the intervention group vs the usual care group (-13.1 vs -7.1 mm Hg, P = .006 for systolic; -6.5 vs -4.2 mm Hg, P = .07 for diastolic). Adherence to medications was similar between the 2 groups, but intervention patients had a greater increase in medication regimen intensity.
.   CONCLUSIONS: A multimodal intervention of patient education, home BP monitoring, BP measurement reporting to an IVR system, and clinical pharmacist follow-up achieved greater reductions in BP compared with usual care. - Bayliss EA, Bhardwaja B, Ross C, Beck A, Lanese, DM. Multidisciplinary Team Care May Slow the Rate of Decline in Renal Function. Clin J Am Soc Nephrol. 2011 Apr;6(4):704-10. PMID: 21273376. OBJECTIVE: A multidisciplinary team (MDT) approach to chronic kidney disease (CKD) may help optimize care of CKD and comorbidities. We implemented an MDT quality improvement project for persons with stage 3 CKD and comorbid diabetes and/or hypertension. Our objective was to decrease the rate of decline of GFR. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We used a 4-year historical cohort to compare 1769 persons referred for usual nephrology care versus 233 referred for MDT care within an integrated, not-for-profit Health Maintenance Organization (HMO). Usual care consisted of referral to an outside nephrologist. The MDT consisted of an HMO-based nephrologist, pharmacy specialist, diabetes educator, dietitian, social worker, and nephrology nurse. Both groups received usual primary care. The primary outcome was rate of decline of GFR. Secondary outcomes were LDL, hemoglobin A1c, and BP. RESULTS: In multivariate repeated-measures analyses, MDT care was associated with a mean annual decline in GFR of 1.2 versus 2.5 ml/min per 1.73 m2 for usual care. In stratified analyses, the significant difference in GFR decline persisted only in those who completed their referrals. There were no differences in the secondary outcomes between groups. CONCLUSIONS: In this integrated care setting, MDT care resulted in a slower decline in GFR than usual care. This occurred despite a lack of significant differences for secondary disease-specific measures, suggesting that other differences in the MDT population or care process accounted for the slower decline in GFR in the MDT group. Tumor Board and Cancer Registry Colorado Health Plan collects specific cancer patient data to be sent to the state at particular intervals after diagnosis. Each patient is followed on an annual basis for the remainder of his or her life. Educational Theatre Programs The Colorado Health Plan spent approximately $1.7 million in 2011 to produce the Educational Theatre Programs (ETP) in Colorado. Since 1985, ETP has provided free, award-winning, health education programs reaching almost three million people in Colorado. In 2011, the Colorado ETP program touched approximately 147 thousand people. Following are highlights of the various program offerings: - Choose Your Life - A bullying prevention play for upper elementary students based on the evidence based Olweus bully proofing program that promotes a caring school climate. - Amazing Food Detective - An interactive theatre program for elementary students that delivers four key nutrition and activity messages and supports the HEAL community health initiative. - Teens Take It On - A youth engagement program that involves high school students as peer educators and advocates for health. Teens work in partnership with adults, school districts and community organizations to address health issues. The issues addressed align with community benefit focus areas and initiatives. - It's Your Health - A fun, fast educational game that promotes healthy eating and active living. The game is used to activate Kaiser Permanente sponsorships and engage people at community events. - Educational Theatre Internship Program - Students from Metropolitan State College serve as interns and tour two days a week presenting Health Team Four, a play that delivers HEAL messages to upper elementary students. - Situational Communications - A positive communication skills workshop for families of teens and adolescents to improve family relationships. - Laugheceuticals -Laughter as Wellness. An interactive workshop engaging participants in activities that promote interaction, positive communication and highlight the health benefits of laughter. - Care Equity Project - A collaborative effort involving the Kaiser Permanente Safety Net team, ETP and other community and KP partners. The project provides awareness building and education to assist community providers and Kaiser Permanente staff and physicians in caring for low income patients. The project offerings include a theatre piece called Loose Change, as well as 4 Care Equity Workshops. Continuing Medical Education Continuing Medical Education (CME) provides physicians with the tools to continue to educate themselves about new, innovative practices, better ways to care for patients and more. In 2011, the Colorado region provided 696 credit hours to physician education. An example of community-based CME courses offered is - In 2011, 8 accredited course hours were provided to safety net physicians to learn about the importance of providing the medication bundle A-L-L (aspirin, lipid lower medication and a statin) to patients at risk for heart events. This medication bundle is proven to reduce heart events for at-risk patients by over 50%. Graduate Medical Education Colorado Health Plan spent approximately $7.9 million to support the graduate medical education of 100+ residents in collaboration with the University of Colorado. The program runs two tracks, From January through June, residents rotate through preventive medicine, urology, and otolaryngology. From July through December, residents rotate through urology and otolaryngology. Nurse Practitioner and Other Non-Physician Training Programs Colorado Health Plan spent approximately $1.8 million in training programs for physician assistants, pharmacy residents, technicians, and other non-physician health professionals. During 2011, the Health Plan supported the training and education of students, interns and externs pursuing a career, or working in, the health care field including preceptorships, clinical internships nursing students and rotations with Permanente physicians for physician assistants from Red Rock Community College. Several programs are described below. Nurse Precepting - Colorado Health Plan offers nurses the opportunity for preceptorship in primarily outpatient settings. Nearly 300 community nurses participate in this program annually. Pharmacy Programs supported by Colorado Health Plan Pharmacy Student Advanced Experiential Program - Experiential unpaid training opportunities exist for Pharmacy students, in their last/fourth year of pharmacy school, from Colorado and other states. Students spend time at each of the medical offices in the Colorado region in a variety of outpatient, operational, clinical and specialty areas within pharmacy services. These rotations are generally 4-6 weeks in length and are full-time (160-240 hours per externship). Students are able to have "hands-on" learning in the provision of care to our members. Pharmacy Student Introductory Experiential Program - Experiential unpaid training opportunities exist for Pharmacy students in their 2nd or 3rd year of training from Colorado and other states. Students spend time in outpatient pharmacies, or may spend time in specialty areas, to gain early experience in pharmacy services. These experiences vary between 9 to 72 hours per semester and serve the purpose of getting students early exposure, as well as possibly sparking interest in Kaiser Permanente as a future site of training and employment. Pharmacy Intern Program - Interns are pharmacy students in various stages of pharmacy school who desire to acquire "hands on" training. Interns at KPCO have a paid, structured learning experience that involves set objectives and experiences, and incorporates organized learning sessions. Interns generally work 8-12 hours per week during school and full time during the summer in the outpatient pharmacies. The "Clinical Intern" program allows a certain number of existing outpatient interns to work in Clinical Pharmacy Services, in order to broaden their exposure to all aspects of the Pharmacy Department. Pharmacy Resident Program - KPCO Health Plan offers a unique Post Graduate Year Two (PGY2) residency training program that provides the opportunity to acquire advanced knowledge and skill in ambulatory care pharmacotherapy in a managed care environment. Residents gain an understanding of managed care pharmacy practice; a practice which balances between evaluating outcomes, managing systems and providing pharmaceutical care to individual patients. Residents are paid employees, but the teaching of residents is on voluntary staff time.
.   Kent M. Nelson Scholarship Program - was created to cultivate student interest in careers in clinical pharmacy. The scholarship winners are awarded monetary assistance as well as a structured program (shadowing opportunities, mentoring sessions, paid research opportunities) with the clinical pharmacy services leadership at KPCO. Pharmacy Technician Training Program - The pharmacy department continues to establish positive relationships with schools and colleges that provide training programs for pharmacy technicians. We are pleased to offer our unique resources as clinical extern sites for technician externs. The pharmacy offers unpaid experiential training opportunities to students enrolled in a pharmacy technician program. Students may complete up to 160 hours of experiential training after finishing their didactic course work. Students partner with a current Kaiser Permanente pharmacy technician to learn all aspects of the job. Various Externships, Internships, and Clinical Rotations/Clinical Internships supported by Colorado Health Plan NURSE PRACTITIONER: KPCO recognizes the growing need to train nurse practitioners as the demand for more primary care providers grows rapidly in Colorado and in the nation. We are pleased to support four very strong nurse practitioner programs including University of Colorado-Denver, University of Northern Colorado, University of Colorado-Colorado Springs Beth El, and Regis University. Students from these prestigious universities work with our talented providers and our state-of-the-art computer systems and equipment to gain knowledge and expertise in their chosen field of advanced practice nursing. In 2013, nurse practitioners will be required to have doctorates and will require more clinical rotation time. Therefore, Kaiser Permanente will continue to be a clinical site for these very important mid-level providers. LABORATORY: The Clinical Laboratory departments at KPCO continue to establish robust relationships with colleges, universities and institutes to promote the laboratory professions and to offer our resources as clinical intern sites for students. We have formed strong partnerships with Arapahoe Community College's Medical Laboratory Technician program and the Medical Technologist Program at the Center for Medical Laboratory Science at Presbyterian/St. Luke's Hospital. These programs have proven to be very successful and will create a much-needed pipeline of possible laboratory technicians/technologists in the future. Kaiser Permanente continues to donate time and equipment to keep these programs running. RADIOLOGY: The multiple Radiology department locations at KPCO also continue to establish very robust relationships with colleges, universities and institutes to promote the radiology professions and to offer our resources as clinical intern sites for students. One example of this partnering is the new Red Rocks Community College Diagnostic Medical Sonographer and Cardiac Diagnostic Medical Sonographer programs, which have been identified as a very difficult-to-fill radiology positions. All of the radiology programs are very successful and Kaiser Permanente Radiology Departments will continue to donate time and equipment to keep these programs running. SOCIAL WORK: The Palliative Care and Oncology Departments at KPCO continue to establish positive relationships with colleges and universities that provide graduate-level programs in Social Work. One example is our partnership with the prestigious University of Denver Graduate School of Social Work. We are pleased to offer our unique resources as clinical intern sites for these students. BEHAVIORAL HEALTH: According to Colorado Workforce development reports, the need for more mental health providers is growing steadily as the population grows. Kaiser Permanente Behavioral Health Department welcomes students from the University of Denver's Counseling Psychology/Couple & Family program. These masters and doctoral students serve nine-month to one-year internships at a Behavioral Health facility. Kaiser Permanente will continue to provide opportunities for these counseling students and will extend the program to include students from the University of Colorado Denver program as well. Grants and Donations for Knowledge Dissemination The Colorado Health Plan donated approximately $32,700 charitable contributions to 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 provider. OTHER COMMUNITY BENEFITS The Colorado Health Plan spent approximately $1.3 million on other community benefit activities and programs beyond the national streams of work. Self-Sufficiency Programs The Colorado Health Plan spent approximately $185,000 to support 25 Undergraduate Pre-Health interns in 2011. Undergraduate Pre-Health Program (UPP): University of Colorado Denver - Anschutz Medical Campus & Kaiser Permanente KP employs 20 interns annually in the form of summer internships and supplemental education for undergraduate students interested in pursuing the health care professions of medicine, nursing, pharmacy & research. The 13-month program offers paid internships for the summer, education, training, and research experiences, and exposure to cadaver and simulation labs. Interns also attend Saturday Academies throughout the school year that included an array of topics from practicing interview skills, to writing personal statements required for application to the professional schools, and engaging in activities that focus on health disparities. Arrup Jesuit High School KP employs 6 college work study program students annually. (Arrup is a college prep school and corporate work-study program that serves underprivileged students of color.) - The corporate work-study program provides students with real world job experiences and exposure to careers while allowing them to earn 70% of their school tuition, which is an integral part of their educational experience and requires that the students are committed to high standards of responsibility and behavior. Other Grants and Donations Colorado Health Plan donated more than $169,491 to nonprofit organizations to address other community benefits beyond the national streams of work. - Denver Botanic Gardens Healthy Environments: Community Supporting Agriculture (CSA) $508,848 over three years Year 2 Summary: Impressive increases in produce grown (10,400 to 45,009 pounds), volunteer engagement (1,015 to 1,683 hours), donations of produce to local nonprofits (34 organizations for 4,188 pounds of produce), and total member "shares" sold (55 to 145). Year 2 additions include two acres of farming, nine crops grown, 25 varieties grown, two CSA internships, a Farm Camp, and four new revenue sources. Finally, project staff have provided significant technical assistance to national and local agencies about the business and technical model of a CSA. A number of additional community organizations were funded in 2011 through grants made to the Denver Foundation. The following are examples: - Health Access Pueblo Health Access: Community share of a multi-share health insurance program $50,000 in 2011 Summary: KPCO funding helped provide accessible health care to 131 working but uninsured individuals in Pueblo County. Health Access Pueblo now has 226 individuals in the plan and serves 69 employee groups. This is a three share (employer, employee, and community share) health coverage model for Pueblo's working uninsured that do not qualify for other insurance programs. - Hunger Free Colorado Healthy Environments: The Hunger Free Hotline $150,000 over two years Year 1 Summary: The comprehensive bilingual, statewide Hunger Free Hotline helps connect families to needed nutrition assistance programs and emergency food resources. The Hotline received an average of 40 calls per day. Referrals included: 4,846 households for a total of 13,090 individuals; 4,201 to food pantries; 3,988 to SNAP; 1,871 to child nutrition programs; 1,327 to soup kitchens, 609 to commodities; 220 to congregate feeding services; 98 to Meal on Wheels; and, 24 to mobile food services.
.   - The Partnership for Families and Children, $5000 Support for a national conference called School Success: Best Practices in Attendance, Attachment, and Achievement on October 26th-28th, 2011 at the Omni Hotel in Broomfield. The conference which reached 500-600 participants increased knowledge of school professionals with best practice tools in : Bully prevention and intervention Prevention truancy and dropout Reduce elementary school absences Align policy and best practices Implement early warning systems Create engaging school climate Engage parents Create effective school partnerships Regional Community Benefit Operations The Colorado Health Plan has a dedicated Community Benefit Department with 32 full time employees to support regional community benefit programs and services and coordinate CB initiatives. VOLUNTEERISM Our volunteer mission is to serve the community in ways that improve the health of our members and the communities we serve and to work with nonprofit organizations when there is an existing business partnership and mission alignment. We accomplished this mission in 2011 with 1,387 employees engaged in volunteer projects. Here are some of the community partners that we worked with: Jeffco Action Center, Bessie's Hope, Boys & Girls Clubs, Habitat for Humanity, Food Bank of the Rockies, Hunger Free Colorado, MLK Jr Early College, Project C.U.R.E., Visiting Nurses Association, Marion House Soup Kitchen, Family Tree - House of Hope, Metro Community Provider Network, The Bike Depot, Urban Peak, Junior Achievement, Denver Urban Gardens, Goodwill Inc., Community Supported Agriculture (Denver Botanic Gardens), Veterans Associations.
.   ATTACHMENT A 2011 COMMUNITY BENEFIT INVESTMENT - COLORADO REGION The following chart summarizes 2011 Community Benefit investments by the Colorado Health Plan. The investments in the community reflected in the chart are unaudited. REGIONAL HEALTH PLAN TOTAL CARE AND COVERAGE Charitable Care and Coverage Programs $19,260,454 Government-Sponsored Programs 31,046,268 Care & Coverage CB Operations 1,613,282 Subtotal: $51,920,004 COMMUNITY HEALTH INITIATIVES Community Health Education $322,314 Community Health Initiatives CB Operations 318,772 Subtotal: $641,086 SAFETY NET PARTNERSHIPS Grants & Donations for Safety Net Partnerships $98,810 Safety Net CB Operations 218,059 Subtotal: $316,869 KNOWLEDGE DISSEMINATION Medical Research $22,207,360 Educational Theatre Program 1,679,861 Health Care Training and Education Programs 9,860,379 Grants & Donations for Knowledge Dissemination 32,700 Knowledge Dissemination CB operations 709,393 Subtotal: $34,489,693 OTHER COMMUNITY BENEFITS Self Sufficiency Programs $185,435 Grants/Donations for other community benefits 169,491 other CB Operations 933,725 Subtotal: $1,288,651 TOTAL $88,656,303
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Christine Cassel TITLE:Director HOURS:7
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Thomas Chapman TITLE:Director HOURS:10
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Daniel P. garcia TITLE:SVP, Chief Compliance Officer HOURS:48
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:William Graber TITLE:Director HOURS:7
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Eugene Grisby III TITLE:Director HOURS:7
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:George C. Halvorson TITLE:Chairman and CEO HOURS:45
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Judith Johansen TITLE:Director HOURS:6
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Kim J. Kaiser TITLE:Director HOURS:8
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Philip Marineau TITLE:Director HOURS:6
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Jenny Ming TITLE:Director HOURS:5
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Edward Pei TITLE:Director HOURS:8
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:J. Neal Purcell TITLE:Director HOURS:9
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Cynthia Telles TITLE:Director HOURS:7
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:meg porfido TITLE:director HOURS:6
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Sandra Thompkins TITLE:Director HOURS:5
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mitchell S.Cohen TITLE:Region Liaison HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Kathryn Lancaster TITLE:EVP & CFO HOURS:46
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Donna Lynne TITLE:Region President Colorado HOURS:32
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Thomas R. Meier TITLE:SVP, Corporate Treasurer HOURS:47
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Donald H. Orndoff TITLE:SVP, NFS HOURS:45
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ROCHELLE M. Roth TITLE:SENIOR DIRECTOR,QRM HOURS:45
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Arthur M. Southam TITLE:EVP, Health Plan Operations HOURS:45
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Deborah Stokes TITLE:SVP, Controller & Chief Accoun HOURS:46
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Bernard J. Tyson TITLE:President & COO HOURS:45
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Victoria B. Zatkin TITLE:VP, Off of Brd & Corp Gov Svcs HOURS:46
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mark S. Zemelman TITLE:SVP, Gen Counsel & Secretary HOURS:47
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Keith J. Evans TITLE:VP, MSBD - CO HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Jeffrey L. Hahn TITLE:Dir Sales & Acct Mgt HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Anne E. McDow TITLE:VP, Health Plan Admin - CO HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:James Newsome TITLE:VP, CFO - CO HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Nancy L. Wollen TITLE:SVP, Operations HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Jean L. Barker TITLE:Market & Prod Strategy Dir HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Richard Roland Lyon TITLE:VP, Region Strategy Performanc HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Virginia M. McLain TITLE:VP, Primary Care & Med Special HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Robin Sadler TITLE:VP, HR - Colorado HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:John K. Warren TITLE:Sr Sales Director HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Steven R. 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:  
SCHEDULE R
(Form 990)

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

OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
KAISER FDN HEALTH PLAN OF COLORADO
 
Employer identification number

84-0591617
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income



(e)
End-of-year assets


(f)
Direct controlling
entity









(1) HAMI - COLORADO LLC
ONE KAISER PLAZA SUITE 15L
OAKLAND,CA94612
84-0591617
FINANCING DE 0 0 KPHP CO
 










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


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section



(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled organization
Yes No
(1) KAISER FDN HEALTH PLAN OF GEORGIA INC

ONE KAISER PLAZA SUITE 15L

OAKLAND,CA94612
58-1592076
HEALTH CARE GA 501(c)(3) 9 KFHP INC
 
Yes
 
(2) KFHP OF THE MID-ATLANTIC STATES INC

ONE KAISER PLAZA SUITE 15L

OAKLAND,CA94612
52-0954463
HEALTH CARE MD 501(c)(3) 9 KFHP INC
 
Yes
 
(3) 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
 
(4) KAISER FOUNDATION HEALTH PLAN OF OHIO

ONE KAISER PLAZA SUITE 15L

OAKLAND,CA94612
34-0922268
HEALTH CARE OH 501(c)(3) 9 KFHP INC
 
Yes
 
(5) KAISER FOUNDATION HOSPITALS

ONE KAISER PLAZA SUITE 15L

OAKLAND,CA94612
94-1105628
HEALTH CARE CA 501(c)(3) 3 KFHP INC
 
Yes
 
(6) CAMP BOWIE SERVICE CENTER

ONE KAISER PLAZA SUITE 15L

OAKLAND,CA94612
94-3299123
ADMIN CA 501(c)(3) 11 - I KFHP INC
 
Yes
 
(7) KAISER HEALTH ALTERNATIVES

ONE KAISER PLAZA SUITE 15L

OAKLAND,CA94612
93-0954562
HEALTH CARE OR 501(c)(3) 9 KFHP INC
 
Yes
 
(8) 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
 
(9) 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
 
(10) LOKAHI ASSURANCE LTD

ONE KAISER PLAZA SUITE 15L

OAKLAND,CA94612
91-2171891
RISK MGMT HI 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 FOUNDATION HEALTH PLAN INC

ONE KAISER PLAZA SUITE 15L

OAKLAND,CA94612
94-1340523
HEALTH CARE CA 501(c)(3) 9 NA
 
 
No
(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 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
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 V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No
(1) HCMS LLC

ONE KAISER PLAZA SUITE 15L
OAKLAND,CA94612
20-3924985
HEALTH CARE CA NA
 
n/a                
(2) Kaiser Permanente Ventures

one kaiser plaza suite 15l
oakland,CA94612
27-3339892
investment CA na
 
n/a                










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



(b)
Primary activity



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


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

(f)
Share of total income



(g)
Share of
end-of-year
assets

(h)
Percentage
ownership


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




Schedule R (Form 990) 2011
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
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization
(b)
Transaction
type(a-r)
(c)
Amount involved
(d)
Method of determining amount involved
(1) KAISER FOUNDATION HEALTH PLAN INC

K 4,683,834 PER AGREEMENT
(2) KAISER FOUNDATION HEALTH PLAN INC

L 60,348,013 PER AGREEMENT
(3) KAISER FOUNDATION HEALTH PLAN INC

N 86,541 PER AGREEMENT
(4) KAISER FOUNDATION HEALTH PLAN INC

O 43,556,839 PER AGREEMENT
(5) KAISER FOUNDATION HEALTH PLAN INC

P 34,398,440 PER AGREEMENT
(6) KAISER FOUNDATION HEALTH PLAN INC

Q 1,762,210 PER AGREEMENT
(7) KAISER FOUNDATION HOSPITALS

b 180,492,431 PER AGREEMENT
(8) KAISER FOUNDATION HOSPITALS

d 780,805,744 PER AGREEMENT
(9) KAISER FOUNDATION HOSPITALS

l 1,257,365,851 PER AGREEMENT
(10) KAISER FOUNDATION HOSPITALS

o 3,000,320 PER AGREEMENT
(11) KAISER FOUNDATION HOSPITALS

p 500,518,592 PER AGREEMENT
(12) KAISER FDN HEALTH PLAN OF GEORGIA INC

K 194,970 PER AGREEMENT
(13) KAISER FDN HEALTH PLAN OF GEORGIA INC

L 228,566 PER AGREEMENT
(14) KAISER FDN HEALTH PLAN OF GEORGIA INC

N 422,638 PER AGREEMENT
(15) KAISER FDN HEALTH PLAN OF GEORGIA INC

o 12,847 PER AGREEMENT
(16) KAISER FDN HEALTH PLAN OF GEORGIA INC

P 123,330 PER AGREEMENT
(17) KFHP OF THE MID-ATLANTIC STATES INC

K 268,639 PER AGREEMENT
(18) KFHP OF THE MID-ATLANTIC STATES INC

L 503,745 PER AGREEMENT
(19) KFHP OF THE MID-ATLANTIC STATES INC

n 11,365 per agreement
(20) KFHP OF THE MID-ATLANTIC STATES INC

O 71,040 PER AGREEMENT
(21) KFHP OF THE MID-ATLANTIC STATES INC

P 1,396,500 PER AGREEMENT
(22) KAISER FDN HEALTH PLAN OF THE NORTHWEST

K 250,733 PER AGREEMENT
(23) KAISER FDN HEALTH PLAN OF THE NORTHWEST

L 166,527 PER AGREEMENT
(24) KAISER FDN HEALTH PLAN OF THE NORTHWEST

O 9,513 PER AGREEMENT
(25) KAISER FDN HEALTH PLAN OF THE NORTHWEST

P 104,688 PER AGREEMENT
(26) KAISER FDN HEALTH PLAN OF OHIO

K 32,163 PER AGREEMENT
(27) KAISER FDN HEALTH PLAN OF OHIO

L 225,145 PER AGREEMENT
(28) KAISER FDN HEALTH PLAN OF OHIO

n 93,997 per agreement
(29) KAISER FDN HEALTH PLAN OF OHIO

O 2,926 PER AGREEMENT
(30) KAISER FDN HEALTH PLAN OF OHIO

P 543,694 PER AGREEMENT
(31) CAMP BOWIE SERVICE CENTER

L 8,232,249 PER AGREEMENT
(32) CAMP BOWIE SERVICE CENTER

O 651,812 PER AGREEMENT
(33) CAMP BOWIE SERVICE CENTER

P 8,746,100 PER AGREEMENT
(34) KAISER HOSPITAL ASSET MANAGEMENT

L 148,239,104 PER AGREEMENT
(35) KAISER PERMANENTE INSURANCE COMPANY

K 2,854,078 PER AGREEMENT
(36) KAISER PERMANENTE INSURANCE COMPANY

L 18,257,426 PER AGREEMENT
(37) KAISER PERMANENTE INSURANCE COMPANY

p 1,176,508 PER AGREEMENT
(38) LOKAHI ASSURANCE LTD

L 27,924,000 PER AGREEMENT
(39) LOKAHI ASSURANCE LTD

P 5,845,010 PER AGREEMENT
(40) LOKAHI ASSURANCE LTD

q 8,426,000 per agreement
(41) ordway Indemnity

l 249,500 per agreement
Schedule R (Form 990) 2011
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)
(d)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

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


Yes No Yes No Yes No






























Schedule R (Form 990) 2011
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: