Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 34,240 | 55,792 | 90,559 | 105,012 | 13,725 | 299,328 |
| 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...... | 2,817,773,409 | 2,980,226,987 | 3,143,279,380 | 3,315,037,313 | 3,520,930,084 | 15,777,247,173 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513... | 0 | |||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | |||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 6 | Total. Add lines 1 through 5. | 2,817,807,649 | 2,980,282,779 | 3,143,369,939 | 3,315,142,325 | 3,520,943,809 | 15,777,546,501 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | |||||
| 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. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 15,777,546,501 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 2,817,807,649 | 2,980,282,779 | 3,143,369,939 | 3,315,142,325 | 3,520,943,809 | 15,777,546,501 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 19,185,497 | 16,369,318 | 14,364,423 | 14,526,894 | 18,139,668 | 82,585,800 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | 0 | 0 | 0 | 0 | 0 |
| c | Add lines 10a and 10b. | 19,185,497 | 16,369,318 | 14,364,423 | 14,526,894 | 18,139,668 | 82,585,800 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 0 | |||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 2,836,993,146 | 2,996,652,097 | 3,157,734,362 | 3,329,669,219 | 3,539,083,477 | 15,860,132,301 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2015 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
||||
|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
||||
| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
||||
|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
||||
|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| Form 990, part vi, question 6 | Kaiser foundation health plan, inc. is the sole member. Upon dissolution, remaining assets shall be distributed to a 501(c)(3) organization. |
| Form 990, PART VI, QUESTION 7A | KFHP, INC. appoints the directors (and fills vacancies and has authority to remove directors). The same individuals who comprise the board of directors of KFHP also serve as THE directors of KFHP COLORADO, NORTHWEST AND MID-ATLANTIC STATES. |
| Form 990, PART VI, QUESTION 7B | THE FOLLOWING ACTIONS OF THE CORPORATION REQUIRE APPROVAL OF THE SOLE MEMBER: A) REMOVAL OF THE CHAIRMAN OF THE BOARD OR THE PRESIDENT, THE GROUP PRESIDENT OR REGIONAL PRESIDENT; B) AMENDMENT OF ARTICLE D, SECTION D-4 OF THE BYLAWS - ELECTION AND TERM OF OFFICE. |
| Form, PART VI, QUESTION 11B | Form 990 Review Process: 1. Key information necessary for the preparation of the tax return is obtained and/or confirmed with internal sources including regional finance, executive compensation, community benefits, treasury, government relations, and legal. 2. Community benefit reporting details are presented to the community benefit committee of the board for review. 3. Prior to finalization, the return is reviewed by an external tax advisor. 4. Once signed by an external tax advisor, the return and underlying data are reviewed by an officer or a member of management designated by an officer for signature and filing. 5. Copies are then provided to board members prior to filing. |
| Form 990, PART VI, QUESTIONS 12C | COMPLIANCE ENFORCEMENT A. 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: A1. 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. A2. THE NATIONAL COMPLIANCE OFFICE AND 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 A3. ANNUALLY, AS A COMPONENT OF THE EXTERNAL AUDIT, AN OUTSIDE CERTIFIED PUBLIC ACCOUNTING FIRM 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. B. 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: B1. REPRESENTED EMPLOYEES ARE SUBJECT TO ANY CORRECTIVE/DISCIPLINARY ACTION PROVISIONS DESCRIBED IN SPECIFIC REGIONAL/NATIONAL COLLECTIVE BARGAINING AGREEMENTS AND/OR ORGANIZATIONAL POLICIES AND PRACTICES. B2. KAISER PERMANENTE NOTIFIES EMPLOYEES OF THE NATIONAL HUMAN RESOURCES POLICY NO. 14. CORRECTIVE/DISCIPLINARY ACTION POLICY DURING NEW EMPLOYEE ORIENTATION AND IN ANNUAL COMPLIANCE TRAINING. B3. 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, QUESTION 15A/B | COMPENSATION DETERMINATION THE EXECUTIVE COMPENSATION PROGRAM AS ADMINISTERED BY KAISER FOUNDATION HEALTH PLAN, INC. 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 AND THE MANAGEMENT COMMITTEE ON COMPENSATION. PRIOR TO PAYMENT, ALL PROGRAMS AND PAYMENTS TO THE CEO, EXECUTIVE DIRECTOR, AND TOP MANAGEMENT OFFICIALS (EXECUTIVES) ARE REVIEWED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS AND THE MANAGEMENT COMMITTEE ON COMPENSATION. 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 TO BE COMPETITIVE TO 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, MEMBERSHIP GROWTH, FINANCIAL SOUNDNESS, AND THE COMMUNITY AND SOCIAL MISSION OF THE ORGANIZATION. |
| Form 990, PART VI, QUESTION 18 | Forms 990 are available on www.guidestar.org. |
| Form 990, PART VI, QUESTION 19 | Public Inspection Copy: Governing documents, conflict of interest policy are available upon request as disclosed to other regulatory bodies. 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 Independent Auditors' Report. To request copies contact: Vice President, Government Relations Kaiser Foundation Health Plan and Hospitals One Kaiser Plaza, 18th Floor 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 9 | CHANGE IN CAPITAL $ 175,000,000 CHANGE IN pension and other retirement liabilities 79,456,419 BOOK-TO-TAX DIFFERENCE ON SALE OF INVESTMENTS 1,103,741 OTHER THAN TEMPORARY IMPAIRMENT LOSS (5,437,650) ---------------- TOTAL 250,122,510 |
| FORM 990, PART III, LINES 4A - 4D | 2015 Community Benefit Report Kaiser Foundation Health Plan of the Northwest Kaiser Foundation Health Plan of the Northwests Commitment to the Community Kaiser Foundation Health Plan of the Northwest (Northwest Health Plan or KFHP-NW) provides and arranges comprehensive health care services for members on a predominantly prepaid basis. Its contractual obligations to group and individual members are fulfilled by contracting with Kaiser Foundation Hospitals (KFH) and Permanente Medical Group physicians to provide health care services for its members. KFHP-NW strives for excellence in serving its members through market-leading performance in quality and service. As a subsidiary of Kaiser Foundation Health Plan, Inc. (KFHP, Inc.), membership is available without regard to age, sex, race, religion, or national origin, or to the individuals ability to pay. Northwest Health Plan members are broadly representative of the communities served. Once enrolled, a member may maintain membership regardless of health or employment status. As related nonprofit organizations, Kaiser Foundation Health Plan, Inc. and Kaiser Foundation Health Plan of the Northwest are committed to improving the health of communities beyond enrolled membership. Annual investments in a range of Community Benefit programs are a fundamental embodiment of the organizations ongoing commitment to improve the general wellbeing within the broader community. These investments result in intentional, planned, measurable, and accountable benefits intended to address many of the health challenges faced at the individual, local, state, and national levels. In 2007, Kaiser Foundation Health Plan, Inc.s board of directors refined the focus of the organizations Community Benefit programs and established the following four priority areas which have come to be known as "Streams of Work": A. Care and Coverage for Low-Income People Creates and supports programs that lower the financial barriers for the under- and uninsured. B. Community Health Initiatives (CHI) Seeks to measurably improve the health of the communities we serve. Designs, delivers, and sustains long-term programs that engage communities in work to improve conditions in their neighborhoods. C. 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. D. Developing and Disseminating Knowledge Improves health care by sharing our knowledge educating practitioners, advancing research, empowering consumers, and informing policymakers about evidence-based care and health. In addition to the streams of work above, KFHP-NW also made contributions to benefit the communities served in the following areas: E. Other Community Benefit Investments Support Community Benefit activities and programs beyond the national streams of work, including the administrative expenses of regional Community Benefit departments dedicated to supporting the organizations Community Benefit programs and services and coordinating related initiatives. F. Environmental Stewardship Protecting and improving the natural environment is a key component of KFHP-NWs mission to improve the health of the community it serves. Although costs associated with this initiative are not included in the dollars reported as Community Benefit investments, efforts in this area contribute to advancing a broader vision emphasizing healthy people and healthy environments while also improving health care quality and affordability. The following are details of the Community Benefit activities provided by Kaiser Foundation Health Plan of the Northwest: In 2015, Northwest Health Plan served nearly 529,000 members and expended approximately $91.9 million (at cost, net of $86.2 million of related revenues) to support Community Benefit activities. The following summarizes many of the signature Community Benefit programs and services grouped according to the national Streams of Work. |
| A. Care and Coverage for Low-Income People | Improving health care access for those with limited incomes and resources is fundamental to Kaiser Foundation Health Plan of the Northwests mission. In 2015, Northwest Health Plan spent approximately $89.7 million (at cost, net of $86.2 million of related revenues) to address the financing and delivery of health care for populations vulnerable due to socio-economic status, illness, ethnicity, age or other factors. Program beneficiaries (under- and uninsured) received free or discounted care in a Kaiser Permanente facility or by a Permanente provider. A.1. Charitable Care (Medical Financial Assistance and Charitable Health Coverage Programs) In Oregon and Washington, Northwest Health Plan provides charity care to low-income vulnerable populations through the Medical Financial Assistance (MFA) and Charitable Health Coverage (CHC) programs. In 2015, Northwest Health Plan spent approximately $24.2 million (at cost, net of $48 thousand of related revenues) on under- and uninsured patients. A.1.1. Medical Financial Assistance (MFA) Program Northwest Health Plans Medical Financial Assistance program provides financial assistance for emergency and medically necessary services, medications, and supplies to patients with a demonstrated financial need. Patients must receive health care services at a Kaiser Permanente facility and/or from a Kaiser Permanente provider. Eligibility is based upon prescribed levels of income to patients who have exhausted other private and public sources of support. In 2015, KFHP-NW provided approximately $12.4 million (at cost, net of related revenues of $0) of services under this program. At KFHP-NW, uninsured patients receive a discount on hospital and professional charges for emergency or other medically necessary care without an application and regardless of income level. The discount is provided to ensure that an uninsured individual is not charged more for emergency or other medically necessary services than the amounts generally billed to insured individuals receiving equivalent care. Contracted collection agency practices are aligned with the organizations social values and IRC section 501(r). Additionally, any patient experiencing financial hardship due to high medical expenses relative to their income level may qualify for the program under special circumstances. Northwest Health Plans MFA eligibility criteria allows insured patients falling at or below 300% of the Federal Poverty Guidelines (FPG) and uninsured patients falling at or below 350% of FPG to receive full (100%) write off of medical charges. In Oregon and Washington, the MFA program also covers full or partial expenses for dental services if applicants meet qualifying guidelines. In 2015, the MFA program assisted more than 15,000 qualified applicants, including nearly 2,300 patients who were not otherwise covered by a health care plan offered by Kaiser Foundation Health Plan of the Northwest. This population received full or partial forgiveness for 114,000 outpatient visits. A.1.2. Charitable Health Coverage (CHC) Program Charitable Health Coverage is a unique approach to caring for low-income uninsured persons in the community. Eligible participants receive a regular Kaiser Permanente Health Plan membership card and access to the full range of services and providers a much better alternative to potentially costly emergency room visits or hospitalization. This allows Northwest Health Plan to invest in the longer term health of patients and the community. KFHP-NWs CHC programs have a long history of making a real difference in the lives of low-income people who might otherwise have no permanent health care coverage. During 2015, KFHP-NW invested approximately $11.8 million (at cost, net of $48 thousand of related revenues) to support the CHC program. The CHC program included a separately administered premium subsidy that CHC members used for the purchase of a standard off-exchange Kaiser Permanente Individual/Family (KPIF) gold level plan. To ensure that patient cost share obligations do not become a barrier to care, a Medical Financial Assistance award is provided to CHC members at the time of enrollment in the CHC program. Recertification takes place about every two years to confirm that members remain eligible to participate. A.1.2.1. Child Health Program Plus The Child Health Program Plus targets eligible students. This program is open to children of low-income families who reside in one of six school districts and who do not have access to other health insurance options. The program provides comprehensive medical, dental and prescription coverage to children between kindergarten and 12th grade, and these children must come from a household with income up to 350% of the Federal Poverty Guidelines. At the end of 2015, more than 3,800 children were covered by membership in this program. A.2. Participation in Medicaid and Other Government-Sponsored Programs Kaiser Foundation Health Plan of the Northwest has a long history of participating in publicly financed health programs as a nonprofit organization. KFHP-NW participates in Medicaid and other government-sponsored programs under a variety of models, depending on the structure of these programs in each state. In 2015, the Northwest Health Plan provided coverage and services valued at $65.5 million (at cost, net of $86.2 million of related revenues) for members and nonmembers in programs sponsored by the federal and state governments. As of December 2015, KFHP-NWs membership in Medicaid programs exceeded 29,000. This represents an increase of almost 7,000 or 30% from year-end 2014. The Affordable Care Act is having a continuing far-reaching impact on the landscape of government-sponsored programs, as these options are poised to become the key source of health coverage for a significant portion of the American population. KFHP-NW has responded to this challenge by developing organizational strategies to enable individuals whose coverage is changing due to personal or financial circumstances to enroll in a Medicaid program offered by KFHP-NW. Realized and anticipated growth in the organizations Medicaid offerings closely aligns with and supports KFHP-NWs core mission, tax exempt status, credibility in state and federal policy arenas, and community health needs focusing on access to care. To better cope with the expansion of KFHP-NWs Medicaid program, a Medicaid Assistance Center (MAC) was opened for operation in 2014. Center representatives provide specialized enrollment services by assisting callers in understanding Medicaid in their state and the qualifications to enroll in Medicaid with KFHP-NW, with an emphasis on availability of bilingual support. A proactive follow-up process has been implemented to nurture a good foundational relationship with those prospects that elect to receive communications. A.2.1. Medicaid Programs Northwest Health Plan participated in three Medicaid managed care programs in Oregon and Washington as well as a fee-for-service provider for patients who have no formal affiliation with KFHP-NW. In 2015, KFHP-NW expended approximately $58.9 million (at cost, net of $86.2 million of related revenues) to subsidize care under Medicaid. The following describe the programs and target populations. A.2.1.1. Medicaid Managed Care Programs A.2.1.1.1. Oregon Health Plan Northwest Health Plan is a direct contractor with the Oregon Health Plan under a Provider Care Organization contract to deliver primary and specialty care paid by the state. All reporting, analysis, auditing, and member administration is performed by KFHP-NW as a Managed Care Organization. As a result, KFHP-NW is engaged in policy development, program structure, and technical capabilities in partnership with the Oregon Health Plan. Members in this program are enrolled based on eligibility criteria for qualified participants who reside in Marion and Polk counties. A.2.1.1.2. Health Share of Oregon With the establishment of Coordinated Care Organizations in the State of Oregon, KFHP-NW joined other health plans as a risk-accepting entity and founding partner in the management of Medicaid managed care contracts. Currently, KFHP-NW in conjunction with Tuality Healthcare, Care Oregon, and Providence Health Services is ranked as the largest Coordinated Care Organization in the state. Health Share of Oregon serves members in Clackamas, Multnomah, and Washington counties. A.2.1.1.3. Healthy Options Healthy Options is a Medicaid program for low-income individuals that meet eligibility requirements for Medicaid. It is a fully-capitated state program managed by the Washington State Health Care Authority (HCA). Northwest Health Plan provides services to eligible participants who reside in either Clark or Cowlitz counties through a subcontract with Molina Healthcare. |
| A.2.1.2. Medicaid Fee-for-Service | Northwest Health Plan contributed $3.3 million (at cost, net of $3.3 million of related revenues) in subsidized care to Medicaid Fee-for-Service patients during 2015. These patients have no formal membership affiliation with KFHP-NW. When a Medicaid nonmember receives services from Kaiser Permanente providers at hospitals or outpatient services as a result of hospital visit follow-up, these expenses are captured as professional and non-professional losses under the Medicaid nonmember program. A.2.1.3. Child Health Insurance Program (CHIP) In both Oregon and Washington, KFHP-NW participates as a provider in the states Child Health Insurance Program. The program provides health insurance to children whose family income is between 200 percent and 300 percent of the federal poverty level, and who are not eligible for Medicaid. Subsidies are provided on a sliding scale based on income. In both states, the program is governed by the Medicaid contract, and offers the same benefits. Northwest Health Plan incurred net losses of $9.7 million (at cost, net of $11.3 million of related revenues) under this program in 2015. A.2.2. Other Government Programs The Oregon Transitional Reinsurance Program supplements the federal program by helping to pay for high claims costs associated with individuals in previous high risk programs. The Washington Medical Insurance Pool provides coverage to individuals who were enrolled in the prior insurance pool program. Legislation allows the states to spread a portion of the expenses for enrollees across the pools of individuals who are insured wholly or in-part by all health insurers, re-insurers, and stop-loss carriers licensed in each state. Northwest Health Plan incurred net losses of $6.6 million (at cost, net of $0 million of related revenues) under these programs in 2015. |
| E. Other Community Benefit Investments | During 2015, Northwest Health Plan spent $2.2 million to support Community Benefit activities and programs beyond the national streams of work. This included the administrative expenses of a Community Benefit department dedicated to supporting regional Community Benefit programs and services and coordinating related initiatives. |
| F. Environmental Stewardship | Poor environmental quality contributes to disease and economic insecurity. Kaiser Foundation Health Plan of the Northwest has committed itself to protecting and improving the natural environment as a key component of its mission to improve the health of the community it serves. Although costs associated with this initiative are not included in the dollars reported as Community Benefit investments, efforts in this area contribute to advancing a broader vision emphasizing healthy people and healthy environments while also improving health care quality and affordability. To fulfill the organizations commitment to the natural environment, KFHP-NW maintains a governance structure for environmental stewardship that enables the organization to continually improve its environmental performance. This structure includes clearly defined roles, responsibilities, plans and routines, and has resulted in the following five organizational focus areas. These have been selected based on their ability to result in the greatest impact on the environmental forces that shape environmental and human health. - Finding safe alternatives to harmful industrial chemicals - Responding to climate change - Promoting sustainable farming and food choices - Reducing, reusing, and recycling to eliminate waste - Conserving water In each of these focus areas, KFHP-NW has established ambitious goals (including a target to reduce total greenhouse gas emissions by 30% by 2020, compared to a 2008 baseline), implemented initiatives, achieved measurable improvements, and regularly reported progress to the board of directors, staff, and the general public. F.1. Performance Metrics During 2015, key performance indicators for Kaiser Foundation Health Plan of the Northwest included: F.1.1. In Oregon and Washington: F.1.1.1 Medical product categories for which at least 99% of purchased products were free of harmful polyvinyl chloride (PVC) and bis(2-ethylhexyl) phthalate (DEHP) chemicals included: 1. Breast pumps; 2. Enteral nutrition products; 3. Exam gloves; and 4. Vascular catheters. F.1.1.2 Purchased 7.7 million kilowatt-hours of Clean Wind renewable power, thus reducing our organizations annual greenhouse gas emissions by over 2,900 metric tons of CO2-equivalent. F.1.1.3 Improved our energy use intensity (kBtu/rentable square foot) by 4% compared to our 2010 baseline year. F.1.1.4 Increased our spending on "sustainable food" (as defined by the Green Guide to Health Care) to approximately 16% of our overall spending on food. F.1.1.5 Responsibly reused, recycled or composted over 1,700 tons of materials. |
| PART VI, LINE 4 | THE BYLAWS OF THE CORPORATION WERE AMENDED IN 2015 WITH THE FOLLOWING SIGNIFICANT CHANGE: ON MARCH 12, 2015, ARTICLE D, DIRECTORS, SECTION D-2, NUMBER WAS AMENDED TO CHANGE THE NUMBER OF DIRECTORS FROM "UP TO 15" TO "A RANGE OF 13 TO 17". |
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