TY 2016 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(1) Gregory Adams...................................................................... EVP, Group President	6.0 ................. 44.0	X	X	0	2,457,650	688,025
(2) Benjamin Chu...................................................................... EVP,GP & Region President SCAL	0.0 ................. 50.0	X	X	0	2,371,766	164,429
(3) John W Jackson...................................................................... Director	2.5 ................. 0.0	X		38,212	0	0
(4) Jeffrey P Koplan MD MPH...................................................................... Director	1.0 ................. 0.0	X		13,000	0	0
(5) Kathryn Lancaster...................................................................... EVP & CFO	5.0 ................. 45.0	X	X	0	2,681,226	588,601
(6) Julie Miller-Phipps...................................................................... Regional President - SCAL	32.0 ................. 18.0	X	X	0	1,097,514	210,358
(7) Kirkland Mcghee...................................................................... Assistant Secretary	50.0 ................. 0.0		X	0	330,458	75,024
(8) Thomas Meier...................................................................... SVP, Corporate Treasurer	2.0 ................. 48.0		X	0	1,050,818	138,764
(9) Donald Orndoff...................................................................... SVP, NFS	5.0 ................. 45.0		X	0	935,840	216,315
(10) Jacqueline Sellers...................................................................... Assistant Secretary	1.0 ................. 49.0		X	0	265,122	88,088
(11) James Simpson...................................................................... SVP, Finance - BU & ROC	25.0 ................. 25.0		X	0	835,636	197,862
(12) Arthur M Southam MD...................................................................... EVP, Health Plan Operations	5.0 ................. 45.0		X	0	2,775,635	464,416
(13) Deborah Stokes...................................................................... SVP,Corporate Controller & CAO	4.0 ................. 46.0		X	0	503,944	3,920
(14) Bernard Tyson...................................................................... Chairman & CEO	6.0 ................. 44.0		X	0	8,529,498	720,185
(15) Alfonse Upshaw...................................................................... SVP,Corporate Controller & CAO	4.0 ................. 46.0		X	0	616,612	108,314
(16) Cherita White...................................................................... Assistant Secretary	50.0 ................. 0.0		X	0	109,324	65,101
(17) Hong-Sze Yu...................................................................... Assistant Secretary	5.0 ................. 45.0		X	0	304,345	126,932

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) Mark Zemelman........................................................................ SVP, General Counsel & Secy	1.0 .......................49.0	X				0	1,630,173	369,974
(19) James Cullinan........................................................................ VP, MSBD - GA	50.0 .......................0.0		X			0	404,678	120,301
(20) Craig Faerber........................................................................ VP, CFO - Georgia	50.0 .......................0.0		X			0	664,019	134,217
(21) Pamela Hara........................................................................ VP, Qual/Risk Mgmt & Pop Hlth	50.0 .......................0.0		X			0	375,344	83,454
(22) Jonna Kirkwood........................................................................ VP, COO - GA	50.0 .......................0.0		X			0	420,675	162,797
(23) Michael Wathen........................................................................ VP, HPSA - GA	50.0 .......................0.0		X			0	320,870	96,291
(24) Anne Marie Dropp........................................................................ Sales Exec/Rep II	50.0 .......................0.0			X		268,335	0	28,903
(25) Lori K Ehrlich........................................................................ MGT, Account Mgt III	50.0 .......................0.0			X		334,109	0	70,859
(26) Artemus E George........................................................................ MGT, Account Mgt II	50.0 .......................0.0			X		320,384	0	32,467
(27) Kimberly George........................................................................ Regional Controller, GA	50.0 .......................0.0			X		0	278,187	70,571
(28) Beverly Thomas........................................................................ VP, Community & Public Affairs	50.0 .......................0.0			X		0	360,284	97,747
(29) Kerry Kohnen........................................................................ Region President - Georgia	0.0 .......................0.0				X	0	186,410	102,300
(30) Donna Lynne........................................................................ EVP, GP & Region Pres - CO	0.0 .......................50.0				X	0	5,214,011	131,383
(31) Victoria Zatkin........................................................................ VP, Off of Brd & Corp Gov Svcs	5.0 .......................45.0				X	0	216,783	1,728

(A) Name and business address	(B) Description of services	(C) Compensation
SOUTHEASTERN PERMANENTE MEDICAL GRO, 3495 PIEDMONT ROAD NE ATLANTA,GA30305	MEDICAL SERVICES	320,282,274
NORTHSIDE HOSPITAL, PO BOX 101818 ATLANTA,GA30392	MEDICAL SERVICES	135,841,437
PIEDMONT HOSPITAL INC, PO BOX 102526 ATLANTA,GA30368	MEDICAL SERVICES	55,335,836
GRADY'S MEMORIAL HOSPITAL CORPORATI, PO BOX 930704 ATLANTA,GA31193	MEDICAL SERVICES	32,203,727
CHILDREN'S HEALTHCARE OF ATLANTA, PO BOX 116101 ATLANTA,GA30368	MEDICAL SERVICES	22,313,952
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 242

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

KAISER FOUNDATION HEALTH PLAN OF GEORGIAINC

Employer identification number

58-1592076

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

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

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

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

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

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

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

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

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

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

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

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2019

Page 2

Part II

Support Schedule for Organizations Described in Sections 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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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

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

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

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2018. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990 or 990-EZ) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .	4,664,485	3,067,751	1,422,285	1,573,823	1,123,474	11,851,818
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose	1,131,979,156	1,153,215,348	1,273,100,973	1,385,080,975	1,542,623,138	6,485,999,590
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	1,136,643,641	1,156,283,099	1,274,523,258	1,386,654,798	1,543,746,612	6,497,851,408
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.)						6,497,851,408

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
9	Amounts from line 6...	1,136,643,641	1,156,283,099	1,274,523,258	1,386,654,798	1,543,746,612	6,497,851,408
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..	2,761,470	2,461,505	3,508,275	3,960,516	4,581,095	17,272,861
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.		9,142	7,347	31,809	30,076	78,374
c	Add lines 10a and 10b.	2,761,470	2,470,647	3,515,622	3,992,325	4,611,171	17,351,235
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.)..	1,139,405,111	1,158,753,746	1,278,038,880	1,390,647,123	1,548,357,783	6,515,202,643

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

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

99.734 %

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

99.731 %

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

0.266 %

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

0.268 %

19a

331/3% support tests—2019. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2018. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990 or 990-EZ) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2019

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

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 2019 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-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Name of the organization

KAISER FOUNDATION HEALTH PLAN OF GEORGIAINC

Employer identification number

58-1592076

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

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

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 its Form 990PF, Part I, line 2, to certify that it doesn't 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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization KAISER FOUNDATION HEALTH PLAN OF GEORGIAINC

Part I Contributors	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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization KAISER FOUNDATION HEALTH PLAN OF GEORGIAINC		Employer identification number 58-1592076

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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 4


Name of organization KAISER FOUNDATION HEALTH PLAN OF GEORGIAINC			Employer identification number 58-1592076
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. 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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

If the organization answered "Yes" on 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" on 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" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

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

Name of the organization

KAISER FOUNDATION HEALTH PLAN OF GEORGIAINC

Employer identification number

58-1592076

Part I-A

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

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2019

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 SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) Total

2a	Lobbying nontaxable 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) 2019

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 on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

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

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

Yes

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

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

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

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

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

Yes

314,916

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

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

Yes

37,500

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

352,416

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

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

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

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

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

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
SCHEDULE C, PART II-B, LINE 1A THROUGH 1I	LOBBYING ACTIVITY BY NONELECTING PUBLIC CHARITIES THE ORGANIZATION (HEALTH PLAN) IS A MEMBER OF THE KAISER PERMANENTE MEDICAL CARE PROGRAM AND PARTICIPATED IN AND BENEFITED FROM LOBBYING ACTIVITIES CONDUCTED AT THE REGIONAL AND NATIONAL LEVELS FOR THE BENEFIT OF ITS ENROLLED MEMBERS, THE BROADER COMMUNITY AND FOR THE HEALTH CARE INDUSTRY AS A WHOLE. AS AN ORGANIZATION EXEMPT FROM INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(C)(3), HEALTH PLAN HAS A POLICY PROHIBITING ANY OF HEALTH PLAN'S RESOURCES BEING USED IN ANY POLITICAL CAMPAIGNS. THIS POLICY IS CLOSELY MONITORED FOR COMPLIANCE. DURING THE YEAR THIS ORGANIZATION MADE COMMENTS OR STATEMENTS CONCERNING LEGISLATION AND BALLOT INITIATIVES WHICH MAY AFFECT THE HEALTH CARE INDUSTRY. HEALTH PLAN ENGAGED IN CONVERSATIONS WITH AND/OR WRITTEN COMMUNICATIONS TO VARIOUS FEDERAL, STATE, AND LOCAL OFFICIALS REGARDING MATTERS WHICH AFFECTED THE HEALTHCARE INDUSTRY AS A WHOLE. THE AMOUNT OF MONEY INVOLVED IN THE ACTIVITIES IS DETAILED ON LINES A THROUGH I. HEALTH PLAN EMPLOYS INDIVIDUALS, INCLUDING ONE OR MORE REGISTERED LOBBYISTS AND/OR MAY RETAIN ONE OR MORE PROFESSIONAL CONSULTANTS TO REPRESENT HEALTH PLAN'S INTERESTS IN VARIOUS LEGISLATIVE AND REGULATORY BODIES AND FROM TIME-TO-TIME TO KEEP INFORMED ABOUT 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 INTERESTS OF HEALTH PLAN, ITS MEMBERS AND ITS PATIENTS 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 AND THE BROADER COMMUNITY IN A COST EFFECTIVE MANNER. - 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. - PREPARING WRITTEN AND ORAL TESTIMONY, APPEARING AT LEGISLATIVE HEARINGS, MONITORING LEGISLATIVE PROCEEDINGS AND MEETING WITH LEGISLATORS AND/OR THEIR STAFFS REGARDING ISSUES PERTINENT TO THE MISSION OF HEALTH PLAN. 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 AND PATIENTS 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.

Return Reference

Explanation

SCHEDULE C, PART II-B, LINE 1A THROUGH 1I

LOBBYING ACTIVITY BY NONELECTING PUBLIC CHARITIES THE ORGANIZATION (HEALTH PLAN) IS A MEMBER OF THE KAISER PERMANENTE MEDICAL CARE PROGRAM AND PARTICIPATED IN AND BENEFITED FROM LOBBYING ACTIVITIES CONDUCTED AT THE REGIONAL AND NATIONAL LEVELS FOR THE BENEFIT OF ITS ENROLLED MEMBERS, THE BROADER COMMUNITY AND FOR THE HEALTH CARE INDUSTRY AS A WHOLE. AS AN ORGANIZATION EXEMPT FROM INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(C)(3), HEALTH PLAN HAS A POLICY PROHIBITING ANY OF HEALTH PLAN'S RESOURCES BEING USED IN ANY POLITICAL CAMPAIGNS. THIS POLICY IS CLOSELY MONITORED FOR COMPLIANCE. DURING THE YEAR THIS ORGANIZATION MADE COMMENTS OR STATEMENTS CONCERNING LEGISLATION AND BALLOT INITIATIVES WHICH MAY AFFECT THE HEALTH CARE INDUSTRY. HEALTH PLAN ENGAGED IN CONVERSATIONS WITH AND/OR WRITTEN COMMUNICATIONS TO VARIOUS FEDERAL, STATE, AND LOCAL OFFICIALS REGARDING MATTERS WHICH AFFECTED THE HEALTHCARE INDUSTRY AS A WHOLE. THE AMOUNT OF MONEY INVOLVED IN THE ACTIVITIES IS DETAILED ON LINES A THROUGH I. HEALTH PLAN EMPLOYS INDIVIDUALS, INCLUDING ONE OR MORE REGISTERED LOBBYISTS AND/OR MAY RETAIN ONE OR MORE PROFESSIONAL CONSULTANTS TO REPRESENT HEALTH PLAN'S INTERESTS IN VARIOUS LEGISLATIVE AND REGULATORY BODIES AND FROM TIME-TO-TIME TO KEEP INFORMED ABOUT 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 INTERESTS OF HEALTH PLAN, ITS MEMBERS AND ITS PATIENTS 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 AND THE BROADER COMMUNITY IN A COST EFFECTIVE MANNER. - 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. - PREPARING WRITTEN AND ORAL TESTIMONY, APPEARING AT LEGISLATIVE HEARINGS, MONITORING LEGISLATIVE PROCEEDINGS AND MEETING WITH LEGISLATORS AND/OR THEIR STAFFS REGARDING ISSUES PERTINENT TO THE MISSION OF HEALTH PLAN. 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 AND PATIENTS 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) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on 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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

KAISER FOUNDATION HEALTH PLAN OF GEORGIAINC

Employer identification number

58-1592076

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

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

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

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

Yes No

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

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

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, 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" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB 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 XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB 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)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

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

Cat. No. 52283D

Schedule D (Form 990) 2019

Page 2

Part III

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

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

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

Yes No


b	If "Yes," explain the arrangement in Part XIII 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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

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

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

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

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

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

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. 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 .....	24,120,214		24,120,214
b	Buildings ....	259,815,495	107,251,582	152,563,913
c	Leasehold improvements	41,735,727	31,260,479	10,475,248
d	Equipment ....	116,911,381	88,519,438	28,391,943
e	Other .....	6,014,008	1,355,603	4,658,405
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				220,209,723

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. 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........
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	973,384,634
2. Liability for uncertain tax positions. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2019

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
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 XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
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 XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
SCHEDULE D, PART X, LINE 2	ASC 740 FOOTNOTE THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE UNDER ASC 740.

Schedule D (Form 990) 2019

Additional Data

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Software Version:

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Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

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," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
KAISER FOUNDATION HEALTH PLAN OF GEORGIAINC

Employer identification number
58-1592076

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) ACHIEVE ATLANTA INC 191 Peachtree St Atlanta,GA30303	47-2670990	501(c)(3)	200,000	EVENTS/SCHOLARSHIPS
(2) ACHIEVEMENT REWARDS FOR COLLEGE PO Box 52124 Atlanta,GA30355	58-2004368	501(c)(3)	10,000	EVENTS/SCHOLARSHIPS
(3) ALLIANCE TO REPAIR THE AMERICAN DIET INC 1579 Monroe Dr Atlanta,GA30324	47-2758876	501(c)(3)	8,500	Educate Attendees About Healthy Diets
(4) AMERICAN DIABETES ASSOCIATION INC 1701 N Beauregard St Alexandria,VA22311	13-1623888	501(c)(3)	50,000	Nutrition education for Gwinnett count middle scho
(5) AMERICAN HEART ASSOCIATION 7272 Greenville Ave Dallas,TX75231	13-5613797	501(c)(3)	61,000	Heart failure improvement project
(6) ATLANTA BELTLINE PARTNERSHIP INC 250 Williams St Atlanta,GA30303	56-2464486	501(c)(3)	35,000	Jamboree Health Fair & The Run Walk Go Race
(7) ATLANTA BOTANICAL GARDEN INC 1345 Piedmont ave Atlanta,GA30309	58-1313284	501(c)(3)	47,960	EVENTS/SCHOLARSHIPS
(8) ATLANTA LEADERSHIP DEVELOPMENT 10 Peachtree Atlanta,GA30309	23-7015688	501(c)(3)	6,000	Corporate impact awards
(9) ATLANTA TECHNICAL COLLEGE FOUNDATION INC 1560 Metropolitan Pkwy Atlanta,GA30310	58-2582973	501(c)(3)	9,000	The Schools Annual Fundraiser For Student Scholars
(10) ATLANTA VOLUNTEER LAWYERS FOUNDATION 235 Peachtree St Atlanta,GA30303	58-1364400	501(c)(3)	50,000	Low income unhealthy rental housing remediation
(11) BETHESDA COMMUNITY CLINIC INC 107 Mountain Brook Canton,GA30115	27-4923001	501(c)(3)	30,363	Diabetes & Hypertension Control Problem
(12) CARE AND COUNSELING CENTER OF GEORGIA 1814 Clairmont Rd Decatur,GA30033	58-0899552	501(c)(3)	30,000	Behavioral Health Care Access & Improvement
(13) CENTER FOR BLACK WOMENS WELLNESS CBWW 477 Windsor St Atlanta,GA30312	58-2212203	501(c)(3)	75,000	Clinic expansion to increase people served
(14) COBB COUNTY BOARD OF HEALTH 1650 County Services Pkwy Marietta,GA30008	58-1517015	501(c)(3)	75,000	prenatal care to underserved women
(15) COMMUNITY ADVANCED PRACTICE NURSES INC 173 Boulevard Atlanta,GA30312	58-2435328	501(c)(3)	74,495	Healthcare for homeless & underserved women
(16) CORPORATE VOLUNTEER COUNCIL OF ATLANTA 1100 Peachtree St Atlanta,GA30377	58-2054790	501(c)(3)	19,870	Corporate impact awards
(17) CORPORATION OF MERCER UNIVERSITY THE 1501 Mercer University Dr Macon,GA31207	58-0566167	501(c)(3)	50,000	Funding Scholarships for Pharmacy Students
(18) COVENANT HOUSE GEORGIA INC 1559 Johnson Rd Atlanta,GA30318	13-3523561	501(c)(3)	50,000	Youth Behavioral Health Improvement Program
(19) CRISTO REY ATLANTA JESUIT HIGH SCHOOL 680 W Peachtree St Altanta,GA30308	45-5550340	501(c)(3)	75,000	Student food service program
(20) DIABETES ASSOCIATION OF ATLANTA 100 Edgewood Ave Atlanta,GA30303	58-0973055	501(c)(3)	50,000	Diabetes Prevention & Management
(21) EASTER SEALS NORTH GEORGIA 53 Perimeter Ctr Atlanta,GA30346	58-1919768	501(c)(3)	25,000	Early childhood mental health program
(22) EMORY GENETICS LABORATORY 1762 Clifton Rd Atlanta,GA30322	58-0566256	501(c)(3)	10,000	Synposium for science, te4chnology, engineering &
(23) ENVIRONMENTAL FUND FOR GEORGIA THE 100 Peachtree St Atlanta,GA30303	58-2022001	501(c)(3)	26,900	Park Pride Conference and Two Play Days
(24) FAMILIES FIRST 1105 W Peachtree St Atlanta,GA30309	58-1054331	501(c)(3)	75,000	Funds will support the teenage pregnancy and paren
(25) FAYETTE CARE CLINIC INC 1260 Highway Fayette,GA30214	20-0314897	501(c)(3)	74,661	Health Improvement of obese/diabetic/CVD & achieve
(26) GEORGIA CAMPAIGN FOR ADOLESCENT POWER 1718 PeachTree St Atlanta,GA30309	31-1520709	501(c)(3)	95,000	Direct services for school comprehensive sex educa
(27) GEORGIA FOUNDATION FOR PUBLIC HEALTH 2711 Irwin Way Decatur,GA30030	46-4253565	501(c)(3)	10,000	Healthy GA awards
(28) GEORGIA GWINNETT COLLEGE FOUNDATION 1000 University Center LN Lawrenceville,GA30043	20-5107997	501(c)(3)	40,000	Scholarships For Nursing Students
(29) GEORGIA WATCH 55 Marietta St NW Atlanta,GA30303	16-1639971	501(c)(3)	35,000	Consumer medical debt education
(30) GIRL SCOUTS OF GREATER ATLANTA 5601 N Allen Rd Mableton,GA30126	58-0566190	501(c)(3)	25,000	Healthy Living Program & Obesity Prevention
(31) GOOD NEWS CLINIC 810 Pine St Gainesville,GA30501	58-2058853	501(c)(3)	75,000	Health Improvement of uninsured, low income adults
(32) GOOD SAMARITAN HEALTH & WELLNESS CENTER 175 Samaritan Dr Jasper,GA30143	58-2576315	501(c)(3)	63,000	Improve patients health for diabetes, hypertension
(33) GOOD SAMARITAN HEALTH CENTER INC 1015 Donald Lee Hollowell Pkwy Atlanta,GA30318	58-2373305	501(c)(3)	75,000	Primary/behavioral healthcare integration
(34) GWINNETT TECH FOUNDATION INC 5150 Sugarloaf Parkway Lawrenceville,GA30043	58-2106879	501(c)(3)	10,000	Scholarships For Nursing Students
(35) HANDS OF HOPE CLINIC INC 1010 Hospital Dr Stockbridge,GA30281	42-1591970	501(c)(3)	37,450	Improve patients health for diabetes, hypertension
(36) HANDS ON ATLANTA INC 600 Means St Atlanta,GA30318	58-1861026	501(c)(3)	75,000	Healthy take home meals for students each weekend
(37) HEALTH EDUCATION ASSESSMENT & LEADERSHIP INC 2600 Martin Luther King Jr D Atlanta,GA30311	26-3990559	501(c)(3)	95,000	Westside community health worker program
(38) INTERNATIONAL RESCUE COMMITTEE INC 122 E 42nd St New York,NY10168	13-5660870	501(c)(3)	50,000	Refugee mental health services
(39) ITS THE JOURNEY INC 270 Carpenter Dr Atlanta,GA30328	47-0897591	501(c)(3)	38,500	Atlanta 2 Day Walk For Breast Cancer
(40) JUNIOR ACHIEVEMENT OF GEORGIA 460 Abernathy Rd NE Atlanta,GA30328	58-0598050	501(c)(3)	20,000	JA Finance Park - Student Engagement & Motivation
(41) LEUKEMIA AND LYMPHOMA SOCIETY 3715 Northside Parkway Atlanta,GA30328	13-5644916	501(c)(3)	25,000	Co-Pay Assistance
(42) MCINTOSH TRAIL COMMUNITY SERVICE BOARD 1435 N Expressway Griffin,GA30223	58-2098758	501(c)(3)	75,000	Establish a medical home fo people with mental ill
(43) MOREHOUSE COLLEGE 830 Westview Dr Atlanta,GA30314	58-0566205	501(c)(3)	13,662	M. Agnes Jones Summer LEGO Camp
(44) PALMETTO HEALTH COUNCIL INC 643 Main St Palmetto,GA30268	58-1307597	501(c)(3)	75,000	Primary/behavioral healthcare integration
(45) PARK PRIDE ATLANTA INC 233 Peachtree St Atlanta,GA30303	58-1883895	501(c)(3)	23,300	Park Pride Conference and Two Play Days
(46) PIEDMONT PARK CONSERVANCY INC PO Box 7795 Atlanta,GA30357	58-1551369	501(c)(3)	94,300	2016 Green Market & Landmark Luncheon
(47) ROBERT W WOODRUFF ART CENTER INC 1280 Peachtree Atlanta,GA30309	58-0633971	501(c)(3)	99,000	Annual Campaign & Symphonys Young Musicians Progra
(48) SENIOR SERVICES NORTH FULTON INC 3060 Royal Blvd Alpharetta,GA30022	58-1948370	501(c)(3)	50,000	Senior medical appointment transporation
(49) SOUTH FULTON SENIOR SERVICES INC 3680-82 College Street College Park,GA30337	58-1948408	501(c)(3)	25,000	Nutrition & Behavior to Encourage Senior Wellness
(50) THE ATLANTA WOMEN'S FOUNDATION 50 Hurt Plaza Atlanta,GA30303	58-2380721	501(c)(3)	48,500	Numbers too big to ingore event
(51) THE GOOD SAMARITAN HEALTH CENTER OF COBB 1605 Roberta Dr Marietta,GA30008	32-0045238	501(c)(3)	75,000	Chronic disease management program
(52) TREES ATLANTA INC 225 Chester Ave Atlanta,GA30316	58-1584758	501(c)(3)	9,650	Support The Group's Root ball event
(53) UNITED NEGRO COLLEGE FUND 1805 7th St NW Washington,DC20001	13-1624241	501(c)(3)	13,250	Fundraiser to support college scholarships for stu
(54) UNITED WAY OF GREATER ATLANTA INC 100 Edgewood Ave Atlanta,GA30303	58-0566194	501(c)(3)	500,000	Access to healthcare for underserved populations
(55) UNIVERSITY OF GEORGIA FOUNDATION 394 S Milledge Ave Athens,GA30602	58-6033837	501(c)(3)	65,000	Scholarships For Pharmacy Students
(56) UNIVERSITY OF WEST GEORGIA FOUNDATION 1601 Maple St Carrollton,GA30118	58-6056464	501(c)(3)	75,000	Funding Will Support Nursing Scholarships
(57) VIEW POINT HEALTH 175 Gwinnett Dr Lawrenceville,GA30046	58-2103187	501(c)(3)	35,000	Improve Access to Care Through Integration of Beha
(58) WHOLESOME WAVE GEORGIA INCORPORATED 1070 Colquitt Ave Atlanta,GA30307	45-4816906	501(c)(3)	50,000	Double value coupon program
(59) YOUNG MENS CHRISTIAN ASSOCIATION OF 100 Edgewood Ave Atlanta,GA30303	58-0566253	501(c)(3)	400,000	Early childhood education program and health activ
(60) YOUNG WOMENS CHRISTIAN ASSN 957 North Highland Ave Atlanta,GA30306	93-0386985	501(c)(3)	49,550	YWCAs Salute to Women of Achievement Event

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2019

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation
SCHEDULE I, PART I, LINE 2	PROCEDURES FOR MONITORING THE USE OF GRANTS Y At the end of their funding cycle, grantees are required to submit a final report which delineates accomplishments related to stated objectives. Large grants (typically over $100K) may require quarterly progress reports.

Schedule I (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

KAISER FOUNDATION HEALTH PLAN OF GEORGIAINC

Employer identification number

58-1592076

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

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

Travel for companions Payments for business use of personal residence

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

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

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

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

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

Yes

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

Yes

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

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

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

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

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

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

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

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

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

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

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

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

Cat. No. 50053T

Schedule J (Form 990) 2019

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 on 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 (E) amounts for that individual.

(A) Name and Title		(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 in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Gregory Adams EVP, Group President	(i) (ii)	0 ------------- 895,570	0 ------------- 1,220,621	0 ------------- 341,459	0 ------------- 661,797	0 ------------- 26,228	0 ------------- 3,145,675	0 ------------- 0
2Benjamin Chu EVP,GP & Region President SCAL	(i) (ii)	0 ------------- 271,507	0 ------------- 1,812,183	0 ------------- 288,076	0 ------------- 156,196	0 ------------- 8,233	0 ------------- 2,536,195	0 ------------- 0
3James Cullinan VP, MSBD - GA	(i) (ii)	0 ------------- 220,806	0 ------------- 167,105	0 ------------- 16,767	0 ------------- 100,640	0 ------------- 19,661	0 ------------- 524,979	0 ------------- 0
4Anne Marie Dropp Sales Exec/Rep II	(i) (ii)	61,061 ------------- 0	192,548 ------------- 0	14,726 ------------- 0	9,871 ------------- 0	19,032 ------------- 0	297,238 ------------- 0	0 ------------- 0
5Lori K Ehrlich MGT, Account Mgt III	(i) (ii)	142,313 ------------- 0	187,470 ------------- 0	4,326 ------------- 0	52,892 ------------- 0	17,967 ------------- 0	404,968 ------------- 0	0 ------------- 0
6Craig Faerber VP, CFO - Georgia	(i) (ii)	0 ------------- 366,362	0 ------------- 278,316	0 ------------- 19,341	0 ------------- 99,122	0 ------------- 35,095	0 ------------- 798,236	0 ------------- 0
7Artemus E George MGT, Account Mgt II	(i) (ii)	109,440 ------------- 0	196,577 ------------- 0	14,367 ------------- 0	23,533 ------------- 0	8,934 ------------- 0	352,851 ------------- 0	0 ------------- 0
8Kimberly George Regional Controller, GA	(i) (ii)	0 ------------- 194,346	0 ------------- 80,596	0 ------------- 3,245	0 ------------- 47,481	0 ------------- 23,090	0 ------------- 348,758	0 ------------- 0
9Pamela Hara VP, Qual/Risk Mgmt & Pop Hlth	(i) (ii)	0 ------------- 212,400	0 ------------- 123,970	0 ------------- 38,974	0 ------------- 56,839	0 ------------- 26,615	0 ------------- 458,798	0 ------------- 0
10Jonna Kirkwood VP, COO - GA	(i) (ii)	0 ------------- 245,760	0 ------------- 154,606	0 ------------- 20,309	0 ------------- 135,551	0 ------------- 27,246	0 ------------- 583,472	0 ------------- 0
11Kerry Kohnen Region President - Georgia	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 186,410	0 ------------- 91,499	0 ------------- 10,801	0 ------------- 288,710	0 ------------- 0
12Kathryn Lancaster EVP & CFO	(i) (ii)	0 ------------- 823,192	0 ------------- 1,486,990	0 ------------- 371,044	0 ------------- 570,456	0 ------------- 18,145	0 ------------- 3,269,827	0 ------------- 15,594
13Donna Lynne EVP, GP & Region Pres - CO	(i) (ii)	0 ------------- 250,147	0 ------------- 1,703,753	0 ------------- 3,260,111	0 ------------- 120,565	0 ------------- 10,818	0 ------------- 5,345,394	0 ------------- 2,322,965
14Kirkland Mcghee Assistant Secretary	(i) (ii)	0 ------------- 222,372	0 ------------- 103,193	0 ------------- 4,893	0 ------------- 57,271	0 ------------- 17,753	0 ------------- 405,482	0 ------------- 0
15Thomas Meier SVP, Corporate Treasurer	(i) (ii)	0 ------------- 382,345	0 ------------- 523,823	0 ------------- 144,650	0 ------------- 111,392	0 ------------- 27,372	0 ------------- 1,189,582	0 ------------- 42,160
16Julie Miller-Phipps Regional President - SCAL	(i) (ii)	0 ------------- 506,896	0 ------------- 302,297	0 ------------- 288,321	0 ------------- 192,552	0 ------------- 17,806	0 ------------- 1,307,872	0 ------------- 0
17Donald Orndoff SVP, NFS	(i) (ii)	0 ------------- 418,115	0 ------------- 491,764	0 ------------- 25,961	0 ------------- 185,822	0 ------------- 30,493	0 ------------- 1,152,155	0 ------------- 0
18Jacqueline Sellers Assistant Secretary	(i) (ii)	0 ------------- 195,357	0 ------------- 60,644	0 ------------- 9,121	0 ------------- 75,309	0 ------------- 12,779	0 ------------- 353,210	0 ------------- 0
19James Simpson SVP, Finance - BU & ROC	(i) (ii)	0 ------------- 368,952	0 ------------- 430,444	0 ------------- 36,240	0 ------------- 173,898	0 ------------- 23,964	0 ------------- 1,033,498	0 ------------- 0
20Arthur M Southam MD EVP, Health Plan Operations	(i) (ii)	0 ------------- 851,992	0 ------------- 1,521,837	0 ------------- 401,806	0 ------------- 438,204	0 ------------- 26,212	0 ------------- 3,240,051	0 ------------- 7,159
21Deborah Stokes SVP,Corporate Controller & CAO	(i) (ii)	0 ------------- 42,705	0 ------------- 395,366	0 ------------- 65,873	0 ------------- 2,147	0 ------------- 1,773	0 ------------- 507,864	0 ------------- 0
22Beverly Thomas VP, Community & Public Affairs	(i) (ii)	0 ------------- 198,605	0 ------------- 114,328	0 ------------- 47,351	0 ------------- 83,613	0 ------------- 14,134	0 ------------- 458,031	0 ------------- 0
23Bernard Tyson Chairman & CEO	(i) (ii)	0 ------------- 1,274,847	0 ------------- 6,056,494	0 ------------- 1,198,157	0 ------------- 686,080	0 ------------- 34,105	0 ------------- 9,249,683	0 ------------- 0
24Alfonse Upshaw SVP,Corporate Controller & CAO	(i) (ii)	0 ------------- 330,597	0 ------------- 250,737	0 ------------- 35,278	0 ------------- 83,390	0 ------------- 24,924	0 ------------- 724,926	0 ------------- 0
25Michael Wathen VP, HPSA - GA	(i) (ii)	0 ------------- 195,840	0 ------------- 107,125	0 ------------- 17,905	0 ------------- 70,027	0 ------------- 26,264	0 ------------- 417,161	0 ------------- 0
26Cherita White Assistant Secretary	(i) (ii)	0 ------------- 100,084	0 ------------- 7,260	0 ------------- 1,980	0 ------------- 33,004	0 ------------- 32,097	0 ------------- 174,425	0 ------------- 0
27Hong-Sze Yu Assistant Secretary	(i) (ii)	0 ------------- 219,652	0 ------------- 68,784	0 ------------- 15,909	0 ------------- 104,663	0 ------------- 22,269	0 ------------- 431,277	0 ------------- 0
28Victoria Zatkin VP, Off of Brd & Corp Gov Svcs	(i) (ii)	0 ------------- 25,068	0 ------------- 99,763	0 ------------- 91,952	0 ------------- 1,394	0 ------------- 334	0 ------------- 218,511	0 ------------- 85,158
29Mark Zemelman SVP, General Counsel & Secy	(i) (ii)	0 ------------- 547,086	0 ------------- 839,524	0 ------------- 243,563	0 ------------- 339,949	0 ------------- 30,025	0 ------------- 2,000,147	0 ------------- 0

Schedule J (Form 990) 2019

Page 3

Part III

Supplemental Information

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

Return Reference	Explanation
SCHEDULE J, PART I, LINE 3	- METHODS USED TO ESTABLISH COMPENSATION OF CEO/EXECUTIVE DIRECTOR - THE FILING ORGANIZATION RELIED ON A RELATED ORGANIZATION 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 OF A RELATED ORGANIZATION.
Schedule J, Part I, Line 4A	- Severance Payments - Kerry Kohnen $ 183,077 LISTED PERSONS PARTICIPATED IN ARRANGEMENTS ENTITLING THEM TO SEVERANCE BENEFITS IN THE EVENT OF TERMINATION BY THE ORGANIZATION WITHOUT CAUSE OR DUE TO JOB ELIMINATION. DEPENDING ON POSITION LEVEL, TENURE, AND TERMINATION REASON, SEVERANCE BENEFITS PAYABLE UNDER THESE ARRANGEMENTS PROVIDE FOR PAY AND HEALTH BENEFITS CONTINUATION PLUS PAYMENT OF ACCRUED OBLIGATIONS. IN ADDITION, FOR SOME OF THE LISTED PERSONS, SEVERANCE BENEFITS PAYABLE INCLUDE PRORATED INCENTIVE AWARDS FOR PERFORMANCE PERIODS NOT YET ENDED. NONE OF THE LISTED PERSONS PARTICIPATED IN ARRANGEMENTS ENTITLING THEM TO CHANGE-OF-CONTROL PAYMENTS.
SCHEDULE J, PART I, LINE 4b	- SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENT - Gregory Adams $ 292,234 Benjamin Chu 275,641 Kathryn Lancaster 322,425 Donna Lynne 3,229,867 Thomas Meier 105,522 Julie Miller-Phipps 107,654 Arthur M. Southam, MD 352,920 Deborah Stokes 59,716 Beverly Thomas 22,858 Bernard Tyson 815,201 Victoria Zatkin 85,158 Mark Zemelman 197,189 SOME OF THE PARTICIPANTS LISTED IN SCHEDULE J, PART II PARTICIPATED IN NONQUALIFIED SUPPLEMENTAL RETIREMENT PLANS. UNDER THESE PLANS, THE ORGANIZATION MAKES ANNUAL CONTRIBUTIONS TO A NOTIONAL ACCOUNT ON BEHALF OF EACH PARTICIPANT. CONTRIBUTIONS VARY BY POSITION, LEVEL AND PAY, AND VEST OVER TIME BASED ON AGE AND/OR SERVICE. PARTICIPANT ACCOUNTS ARE CREDITED WITH A FIXED RATE OF INTEREST, INVESTED IN AVAILABLE MUTUAL FUNDS OR A COMBINATION OF BOTH. CERTAIN OFFICERS ACCRUE A BENEFIT THAT VESTS BASED ON AGE AND SERVICE AND TARGETS A PERCENTAGE OF FINAL AVERAGE PAY LESS PRIOR PLAN OFFSETS. UNVESTED AMOUNTS ARE SUBJECT TO RISK OF FORFEITURE.
SCHEDULE J, PART I, LINE 7	- NON-FIXED PAYMENTS - THE ORGANIZATION PROVIDED NON-FIXED PAYMENTS TO SOME OF THE PERSONS LISTED. PAYMENTS WERE MADE UNDER INCENTIVE PLANS, BASED ON ATTAINMENT OF ORGANIZATIONAL PERFORMANCE GOALS AND INDIVIDUAL PERFORMANCE, DESIGNED TO SUPPORT THE ORGANIZATION'S MISSION TO PROVIDE HIGH-QUALITY, AFFORDABLE CARE AND IMPROVE THE HEALTH OF ITS MEMBERS AND THE COMMUNITIES IT SERVES.

Schedule J (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

KAISER FOUNDATION HEALTH PLAN OF GEORGIAINC

Employer identification number

58-1592076

Return Reference	Explanation
Form 990, Heading, Item B, Amended Return	Revision of deferred compensation in Part VII and Schedule J for one officer/director. Form 990, Part III, Line 4A-4D 2016 Community Benefit Report Kaiser Foundation Health Plan of Georgia, Inc. Kaiser Foundation Health Plan of Georgia, Inc.s Commitment to the Community Kaiser Foundation Health Plan of Georgia, Inc. (Georgia Health Plan or KFHP-GA) 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 local hospitals and Permanente Medical Group physicians to provide health care services for its members. KFHP-GA 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. Georgia 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 Georgia, Inc. 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 well-being of 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-GA 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-GAs 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 Georgia, Inc.: In 2016, Georgia Health Plan expended approximately $48.2 million (at cost, net of $3.0 million of related revenues) to support Community Benefit activities. Over 303,000 members as well as more than 19,000 Medicaid participants assigned to KFHP-GA under contract with third-party insurers were served. 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 Georgia, Inc.s mission. In 2016, Georgia Health Plan expended approximately $40.3 million (at cost, net of $3.0 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) Georgia Health Plan provides charity care to low-income vulnerable populations through the Medical Financial Assistance (MFA) and Charitable Health Coverage (CHC) Programs. In 2016, Georgia Health Plan spent approximately $28.5 million (at cost, net of related revenues of $0) to support under-and uninsured patients. A.1.1. Medical Financial Assistance (MFA) Program Georgia 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 facilities operated by Kaiser Permanente 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 2016, KFHP-GA provided $14.8 million (at cost, net of related revenues of $0) of services under this program. At KFHP-GA, uninsured patients receive a discount on hospital and professional charges for emergency or other medically necessary care without 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 KPs high medical expense criteria. In Georgia, the MFA Programs eligibility criteria allow patients falling at or below 400% of the Federal Poverty Guidelines (FPG) to receive full (100%) write off of patient out-of-pocket costs. In 2016, more than 5,000 qualifying applicants benefited from this program, receiving full or partial forgiveness for over 50,000 outpatient visits and more than 128,000 prescriptions. A.1.1.1. Community Medical Financial Assistance (CMFA) The MFA program also includes support for community based initiatives, known as Community Medical Financial Assistance (CMFA) programs. CMFA programs are designed to broaden access to health care within the community and help KFHP-GA fulfill its objectives to reduce the financial barriers that limit access to care for qualified low income populations. CMFA programs offered in 2016 included full Medical Financial Assistance, Emergency Medical Financial Assistance, Special Circumstances Financial Assistance, and Community Medical Financial Assistance.
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 Georgia Health Plan to invest in the longer term health of patients and the community. KFHP-GAs CHC programs have a long history of making a real difference in the lives of low-income people who might otherwise have no permanent medical home. During 2016, KFHP-GA invested approximately $13.7 million (at cost, net of related revenues of $0) to support the CHC program. The CHC program includes a separately administered premium subsidy that CHC members use 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. Prospective members are invited to apply during limited annual enrollment periods and after experiencing triggering events. A.1.2.1. Bridge Program Georgia Health Plans Bridge Program is a Charitable Health Coverage program that provides low-income individuals and families with access to health coverage. This program targets adults enrolled in job-based training or community college programs and participants must meet certain eligibility requirements. Participants must be age 64 or younger, and all child dependents must be younger than 26. This program is open to uninsured families with household incomes less than 100% of the Federal Poverty Level who do not have access to other forms of health coverage. Once eligibility requirements are met, KFHP-GA Bridge members receive a KP premium subsidy that helps pay for enrollment in a standard off-exchange KP individual and family product (Gold 500/20 plan) for up to 24 months. These members are also provided with medical financial assistance that covers the cost for medically necessary services provided at facilities operated by KFHP-GA. The Bridge Program communicates its offering primarily through community partners such as social service agencies, workforce development agencies, and local community colleges to support them in addressing the health care coverage needs of low income individuals and families. Over 2,300 members were enrolled in KFHP-GAs Bridge program at the end of 2016. A.2. Participation in Medicaid and Other Government-Sponsored Programs Georgia Health Plan has a long history of providing access to low- and moderate-income individuals as a nonprofit organization. KFHP-GA participates in Medicaid and other government-sponsored programs in Georgia by contracting with intermediaries to provide care. Medicaid beneficiaries receive care as assigned patients of KFHP with KFHP serving as a fee-for-service provider for pediatric primary and specialty care. In 2016, KFHP-GA provided care and services valued at $11.8 million (at cost, net of $3.0 million of related revenues) for participants in programs sponsored by the federal and state governments. Contracts are in place with the following three Care Management Organizations (CMOs): 1) Amerigroup Corporation, 2) Peach State Health Plan, 3) WellCare Health Plans, Inc. In 2016 the state of Georgia contracted CareSource as the 4th CMO to manage Medicaid patient care on behalf of the state. KPHP of Georgia is in the contracting phase to offer services to CareSource Medicaid members starting in July 2017. The Affordable Care Act has had a far-reaching impact on the landscape of government-sponsored programs. These options have become key sources of health coverage for a significant portion of the American population. KFHP-GA has responded to this challenge by developing organizational strategies to enable individuals whose coverage is changing due to personal or financial circumstances to obtain medical care at a KFHP-GA facility. Realized and anticipated growth in the organizations Medicaid offerings closely aligns with and supports Georgia Health Plans core mission, tax exempt status, credibility in state and federal policy arenas, and community health needs focusing on access to care. A.2.1. Assignment of Medicaid Participants Georgia Health Plan participates in the federal Medicaid program as a provider of pediatric primary and specialty care through contracts with Amerigroup Community Care, Peach State Health Plan, and WellCare Health Plans. At the end of 2016, KFHP-GA was caring for more than 19,500 pediatric patients whose care has been assigned to the organization by these Medicaid plans. This represents an decrease of 8,000 participants or approximately 41% since 2015 due to a validation of membership counts by one of the three organizations with whom KFHP-GA contracts. The agreements yielded $11.8 million of losses in 2016 (at cost, net of $3.0 million of related revenues). A.2.2. Child Health Insurance Program (CHIP) In Georgia, KFHP-GA participates as a provider in the states Child Health Insurance Program as part of its Medicaid Program. The program provides health insurance to children whose family income meets certain income eligibility requirements, and who do not qualify for Medicaid. KFHP-GAs investment in the CHIP program is included in the amounts detailed in A.2.1 for 2016. B. Community Health Initiatives The Community Health Initiatives (CHI) strategy aims to improve the health of individuals, families, and communities by addressing the social, economic, and environmental determinants of health. Research supports the central premise that excellent medical care alone is insufficient to create healthy people in healthy communities. Evidence underscores the importance of changing community environments as a critical community health strategy. Guided by this evidence, Kaiser Foundation Health Plan of Georgia, Inc. supports comprehensive initiatives that focus on policy and environmental changes to promote healthy eating and active living (HEAL), community safety, economic stability, and social and emotional wellness. Two of the primary programs supported within the CHI Stream of Work include: Healthy Eating, Active Living (HEAL) and obesity prevention Healthy eating, active living has been and continues to be a compelling focus for Kaiser Foundation Health Plan of Georgias work, as obesity continues to be a significant and pervasive public health problem. Despite encouraging signs of obesity rates leveling off in recent years, substantial racial and ethnic disparities continue to exist. Also, through a focus on healthy eating and active living, Georgia Health Plan can have a marked impact on a wide range of health conditions including pre-diabetes, diabetes, cardiovascular disease and several cancers that are affected by these behaviors. Finally, a focus on nutrition, physical activity and weight management are highly aligned with Georgia Health Plans clinical expertise in this area, including a prevention orientation and a number of existing programs and partnerships. Wherever possible, KFHP-GA supports a concentration of multiple strategies that enable sustainable change towards healthy eating and active living lifestyles. These include policies and practices to reduce the availability and consumption of sugar-sweetened beverages, encourage the establishment of safe spaces, promote active transportation policies that support equitable public transit, and create connections between health clinics and community resources. Thriving Schools Thriving Schools is an initiative to improve healthy eating, physical activity, and social and emotional wellness in K-12 schools within Kaiser Foundation Health Plan of Georgias geographic service areas. Thriving Schools efforts focus on policy, systems, and environmental changes that make the healthy choice the easy choice. Interventions aim to create a culture of health on school campuses to spur individual behavior change targeting students, teachers, and staff. In 2016, Georgia Health Plan spent approximately $2 million to support Community Health Initiatives that addressed needs underscored by recent Community Health Needs Assessments obesity and related conditions, economic security, violence/injury prevention, climate and health, and transportation and built environment.
B.1. CHI Programs and Services	Georgia Health Plan works with community-based organizations to design, deliver, and sustain long-term efforts that improve the conditions of neighborhoods, workplaces, schools, and other settings so that they promote good health. The CHI strategy is informed by the regions Community Health Needs Assessment and Implementation Strategy (IS). KFHP-GA, in partnership with the Georgia Department of Public Health, United Way of Greater Atlanta, Atlanta Regional Commission, Morehouse School of Medicine and Grady Hospital hosted a convening of Community Health Workers and other like-minded stakeholders in the state to discuss the future of care coordination and health improvement in Georgia. The event drew a crowd of over 150 attendees from all over the state and the partners are continuing to organize around issues of credentialing, training and reimbursement and will be convening an advisory council to tackle these issues. The 2016 CHI program heavily involved the "Thriving Schools" initiative, which is KFHP-GAs effort to improve healthy eating, physical activity, and school climate in K-12 schools within the Kaiser Foundation Health Plan of Georgia service area. The initiative supported the allocation of financial resources to organizations serving schools and school districts within Metro Atlanta, while providing strategic interventions for targeted, high need & under resourced school communities. Highlights from 2016 include support with college application and enrollment for Atlanta Public School (APS) high school junior and seniors through Achieve Atlanta organization. Additionally, Georgia Lions Lighthouse Foundation through KFHP-GA was able to support vision screening exams for 845 APS and Fulton County School students and provide corrective eyewear for students failing exams. Finally, in partnership with Morehouse, the Corporation for National Community Service, KFHP-GA helped with cost to implement an after summer school robotics camp for summer school participants within the M. Agnes Jones Elementary School cluster. To reach a broader audience, Georgia Health Plan primarily focuses on the following areas through community coalitions, health activism, and community investments: - Healthy food access - Active transportation (walking and biking) - School health - Community-clinic integration B.2. CHI Investments in the Community Kaiser Foundation Health Plan of Georgia, Inc.s investments in the CHI Stream of Work during 2016 included the following: B.2.1. Standing with our Neighbors/Healthy Homes Initiative Georgia Health Plan, in support of Atlanta Volunteer Lawyers Foundation, contributed $50,000 in 2016 for the Standing with our Neighbors/Healthy Homes Initiative to help with their goal to contribute to the stabilization of low-income communities, by addressing health issues driven by unstable and unhealthy rental housing. After 3 months of implementation, 30 Households (representing 87 individuals including children) were served and 50 percent of the households in receipt of support received a mold test due to asthma-related conditions in the home. B.2.2. Double Value Coupon Program (DVCP) In 2016, Wholesome Wave Georgia (WWG) received a $50,000 contribution from KHFP GA to support DVCPs goal to create access to and affordability of healthy food for Financial Nutrition Assistance (FNA) recipients in Georgia. One of several goals is to increase the consumption of fresh, healthy, locally grown food by FNA recipients in Georgia, bringing an increase in overall health and a decrease in obesity, diabetes, heart disease, hypertension, and stroke to this population. The program has served 1,420 individuals. In addition, 80 percent of individuals surveyed reported that they increased their fruit and vegetable intake. B.2.3. Mental Health and Wellness Program (MHWP) The International Rescue Committee (IRC) received a $50,000 grant from KFHP GA to help promote its program for Refugee Mental Health and Well-Being. This project will give more adult refugees access to mental health and wellness services and Intensive Case Management (ICM) by expanding the existing Mental Health and Wellness Program (MHWP). The program has served 29 emotionally at-risk refugees who were identified and enrolled in the IRC in Atlanta's Mental Health and Wellness Program. B.3. Prior Year Contributions In prior years, KFHP-GA made contributions to donor advised funds under the direction of a foundation operating in the local community. These funds were intended to identify and support nonprofit organizations that meet community needs in the area of community health initiatives. In 2016, the following initiative was funded through disbursements issued by the Community Foundation for Greater Atlanta based upon recommendations informed by KFHP-GA's expertise. B.3.1. Atlanta Regional Collaborative for Health Improvement (ARCHI) In 2016, Kaiser Foundation Health Plan of Georgia deepened its engagement with the Atlanta Regional Collaborative for Health Improvement (ARCHI) by making a $250,000 contribution. ARCHI is a public-private coalition formed to improve metro Atlantas health by aligning the regions health and economic interests, investments, and incentives. The collaborative worked to implement the groups chosen strategies of Encouraging Healthy Behaviors, Expanding Insurance, Coordinating Care, and Capturing and Reinvesting savings realized from health improvement. ARCHI DeKalb pilot effort was launched, covering three metro areas to focus its health improvement efforts Columbia, Clarkston and Cross Keys communities all of which are located in a high-need portion of a county within Georgia Health Plans service area. ARCHI hired its first permanent Executive Director to lead coordination of activities and community partners with an expected start date in January 2017. C. Safety Net Partnerships Kaiser Foundation Health Plan of Georgia, Inc. is committed to building partnerships with the institutions that serve on the front lines of health care for the uninsured and underserved. By providing support to community health centers, public hospitals, and local health departments, KFHP-GA helps them deliver care and treatment to the most vulnerable in our communities. KFHP-GA is dedicated to investing in communities and promoting good health for the communities served. As such, Safety Net Partnership (SNP) initiatives aim to strengthen the system of community clinics, public hospitals, and health departments to promote access to high quality care for the uninsured and underserved vulnerable populations. Georgia Health Plan also focuses on improving access to health services and the transformation of care delivery to meet the challenges of the ever evolving performance expectations and revenue design. Efforts to improve access and transform care include work on: increasing access to specialty care services; increasing the utility of health information technology in safety net settings; addressing mental health and wellness, improving population outcomes and eliminating health disparities. KFHP-GA also supports innovative efforts to bring both health care and support services closer to underserved populations through partnerships with school based health centers and community clinics. Investments in Safety Net Partnerships target the following strategic focus areas: I. Care Delivery Transformation II. Capacity Building III. Clinic-Community Integration IV. Policy, Systems, and Environmental Change V. Create and Spread Knowledge VI. Total Health
C.1. Safety Net Programs and Services	Georgia Health Plan spent approximately $1.3 million in charitable contributions associated with safety net priorities in 2016 as 18.9% of the regions residents were without health insurance. KFHP-GAs support of the areas safety net is anchored by a partnership with Grady Health System that is the focal point of care delivery for vulnerable populations in the region, but it also includes partnerships with smaller charitable clinics in less populated areas that are often impacted by physician shortages (increasing barriers to care) and residents poor health status. C.1.1. Good News Clinics Good News Clinics managed a Kaiser Foundation Health Plan of Georgia-funded Clinical and Behavioral Health Intervention Project in 2016. The Clinic served 282 patients as of December 31, 2016 with 47% of patients achieving decreased blood pressure levels; 46% achieving decreased blood sugar levels; 33% decreasing their waist circumferences; 40% increasing their HDL cholesterol levels; and 40% lowering triglyceride levels. C.2. Safety Net Partnerships (SNP) Investments in the Community Georgia Health Plan partnered with several local organizations in 2016 to address community health need priorities. KFHP-GAs investments in the SNP Stream of Work included the following: C.2.1. Cobb County Board of Health In 2016, KFHP of Georgia made a $75,000 grant to Cobb County Department of Health to reduce care barriers for low-income pregnant women. As a result of this donation, 50 women with high-risk pregnancies were provided pre-natal care through the local public health departments Babies Born Healthy project. C.2.2. Community Advanced Practice Nurses (CAP-N) In 2016, nearly $75,000 was awarded to Community Advanced Practice Nurses through a grant seeking to improve the health status of women by providing integrated physical and mental health care services in a medical home, shelter-based setting model of care. In 2016, 85 participants made measurable strides toward improved health status on various measures including achieving healthy blood pressure levels, reducing blood sugar levels and lowering BMI ratios. D. Developing and Disseminating Knowledge The Developing and Disseminating Knowledge Stream of Work supports activities that improve health care by sharing knowledge, educating practitioners, advancing research, empowering consumers and informing policymakers about evidence-based care and health. Kaiser Foundation Health Plan of Georgia, Inc. spent approximately $2.8 million in 2016 to support programs and services associated with the development and dissemination of knowledge. D.1. Medical Research Programs As the largest nonprofit integrated health system in the United States, Kaiser Permanente has a long history of conducting health research related to both prevention and treatment of disease that benefits both Kaiser Foundation Health Plan of Georgia, Inc.s members and the communities that are served. Georgia Health Plans research efforts are core to the collective organizations mission to improve population health, and promote continued learning. Researchers study critical health issues including: cancer, cardiovascular conditions, diabetes, behavioral and mental health, and health care delivery improvement while remaining broadly centered upon the following three themes: - Understanding health risks; - Addressing patients needs and improving health outcomes; and - Informing policy and practice to facilitate the use of evidence-based care. Kaiser Permanente is uniquely positioned to do research due to its rich, longitudinal, electronic clinical databases that capture virtually complete health care delivery, payment, decision-making and behavioral data in detail to support primary, secondary and tertiary clinical care across inpatient, outpatient and emergency department settings for more than 10 million geographically and demographically diverse members. D.1.1. National Research Program Georgias Center for Clinical and Outcomes Research (CCOR) is one of seven regional centers overseen and administered by the Kaiser Foundation Research Institute (KFRI) and three national research infrastructure support centers. Research projects conducted by this collaborative team have yielded findings that affect not only the practice of medicine within the area served by KFHP-GA, but also for society-at-large. The following are descriptions of the entities providing support at the national level. D.1.1.1. Kaiser Foundation Research Institute (KFRI) The Kaiser Foundation Research Institute (KFRI) is a national program established in 1958 to administer and support research at Kaiser Permanente. KFRIs responsibilities include: overseeing and maintaining Kaiser Permanente's relationship with federal granting agencies, providing contract negotiation services for all regional centers, promoting responsible research conduct; and partnering with clinical trials stakeholders across Kaiser Permanente to ensure quality and compliance through the clinical trials program. D.1.1.2. Center for Effectiveness and Safety Research (CESR) The Center for Effectiveness & Safety Research enhances opportunities to answer questions about which interventions work best for whom across all of KPs regional centers by investing in the ongoing development of a common data model, convening researchers and organizational leaders at an annual meeting and via webinars, and by conducting research. The center routinely partners with investigators in KPs regional research centers and with selected operational analytical groups. D.1.1.3. Utility for Care Data Analysis (UCDA) The Utility for Care Data Analysis (UCDA) was created to ensure that analysts and researchers throughout Kaiser Permanente are able to fully realize the analytical potential of Kaiser Permanentes enterprise-wide information systems. This allows experts to compile and compare clinical and utilization data from across Kaiser Permanente in order to assess patterns in health, health care delivery, and clinical quality. UCDA has developed tools for using geographic information systems and providing analytic support for Community Benefit, including the Community Health Needs Assessments. D.1.1.4. Kaiser Permanente Research Bank The Kaiser Permanente Research Bank is a research resource designed to help the organization better understand how peoples health is affected by their genes, behaviors and the environment. It allows researchers to use DNA and other health information voluntarily provided by a diverse cross-section of KP members to study how genetic and environmental factors affect health, and look for new ways to diagnose, treat and prevent certain diseases. KP has set a goal to collect data from a total of 500,000 participants from all seven regional centers, which would make it one of the worlds largest and most diverse repositories of genetic, environmental and health data. To date, more than 250,000 members from four geographic regions, including Georgia, have participated in bio-banking efforts. D.1.2. Georgias Research Program The principal research activities conducted in Georgia take place at the following regional research center: D.1.2.1. The Center for Clinical and Outcomes Research (Georgia region) The Center for Clinical and Outcomes Research (CCOR) was established in 1998 and focuses on research projects and clinical trials that are aligned with the regions strategic objectives. The centers research portfolio and interests center on studies that will help the Georgia region improve the health of its members and the communities it serves. These include such topics as: ways to help people maintain a healthy weight, exercise more or quit smoking, control chronic pain, or manage a chronic disease, as well as implementation science (e.g., testing models of care and implementing and evaluating practice change). Georgia Health Plan provided approximately $838 thousand for medical research projects in 2016. Number of investigators: 1 Number of support staff: 15 Number of journal publications in 2016: 5 Number of clinical trials in 2016: 6 Number of active studies (clinical trials and non-clinical trials) in 2016: 12 Top research areas: - Chronic diseases - Obesity - Cardiovascular and diabetes - Cancer - Behavioral health - Infectious diseases - Health services
D.1.2.2. Major Areas of Funded Research	The following is an example of a research project upon which the Center for Clinical and Outcomes Research (COOR) collaborated during 2016: D.1.2.2.1. HIV Quality Improvement and Performance Program Research Areas: Health Care Delivery and Comparative Health Systems. Collaborating Kaiser Permanente sites: Mid-Atlantic Permanente Research Institute Kaiser Permanente Mid-Atlantic in collaboration with all Kaiser Permanente regions. This study is focused on determining quantitative measures of HIV care quality and outcomes in Kaiser Permanente. Researchers are initiating quality improvement programs where they determine there are opportunities for improvement. Primary Funding Provided By: The Care Management Institute, The Permanente Federation, and Kaiser Foundation Health Plan, Inc. D.2. Educational Theatre Programs (ETP) Confronted with an urgent need for preventive health information in the communities we serve, the Educational Theatre Programs (ETP) was to inspire children, teens and adults to make informed decisions about their health and to build stronger, healthier communities. Georgia Health Plan spent approximately $1.2 million in 2016 to support the Educational Theatre Programs (ETP) in Georgia. ETP is committed to working with schools and nonprofit organizations to pinpoint issues and customize services that are designed to meet specific health related goals. By interacting closely with the audience during live dramatic performances, character appearances, or workshops, educational information is offered to schools and communities free of charge. Programs that are designed to improve the health of Georgia communities are developed by theatre professionals in collaboration with health educators, community advisory committees, health care providers, and physicians. Georgia Health Plans ETP has been teaching healthier living to Metro Atlanta since 1995. During that time, over 1 million people have been reached through empowering messages to improve health. Georgia ETP engages community members through performances and workshops. They are conducted by Actor/Educators who combine developmentally appropriate curriculum and performances with professional theatre practices to engage and teach audience members. Actor/Educators in the performances are ambassadors of good health, reaching audiences through theatre productions that educate and engage audiences about relevant health topics. Audiences learn key messages, including ways to incorporate the information into their lifestyles. Performances are an effective method to engage audiences who may be unfamiliar with the health topic being explored, may be resistant to change, or have not had exposure to the arts. Performances are also a suitable means of reaching audiences composed of diverse members: all-age family-style audiences, diverse socio-economic groupings as well as school, church and other community groups. Performances include theatre plays, character appearances and improvisation-based games and activities. In 2016, ETP held over 1,000 performances for a total audience of nearly 277,000 adults and children. The Educational Theatre staff travel throughout a 32 county area that comprises metro Atlanta. D.3. Professional Training and Education Since 1947, the training of physicians, nurses, and allied health professionals has played a vital role in Georgia Health Plans efforts to serve the health care needs of its members and communities. KFHP-GAs Community Health Needs Assessment in 2013 reported that this continues to be a need with over 43% of the community living in a health professional shortage area. Georgia Health Plan also identified the need to increase linguistic and cultural diversity in the health care workforce. With serious physician and nurse shortages looming in the face of an expected expansion in Americans access to health care, the need to encourage and train a high-quality, diverse, and culturally competent health care workforce is critical, and KFHP-GA is responding in multiple ways. Georgia Health Plan spent approximately $422 thousand in 2016 to support the training for health professionals. By continuing to strategically develop and expand residency programs, the organization will help address societys needs. Kaiser Foundation Health Plan of Georgia, Inc. is uniquely positioned to train future providers because of its high quality, accountable care model, and commitment to community health. D.3.1. Pharmacy Residency Program Georgia Health Plan currently has two post-graduate pharmacy residency programs: a postgraduate year one (PGY1) managed care pharmacy residency and a post-graduate year two (PGY2) ambulatory care pharmacy residency program. The programs are designed to develop accountability; practice patterns; habits; and expert knowledge, skills, attitudes, and abilities in the respective area of pharmacy practice. During 2016, a total of four residents participated in the post-graduate pharmacy programs - two postgraduate year one (PGY1) and two postgraduate year two (PGY2) residents. These residents completed projects that contributed to meeting financial and quality goals within the pharmacy department. They also disseminate the purpose and benefits of residency training by participating in various pharmacy school student meetings about the program and providing didactic lessons at one of the local pharmacy schools. D.3.2. INROADS Leadership Development The INROADS program seeks to increase business career opportunities and knowledge for highly qualified diverse students while giving corporations the opportunity to develop diverse managerial talent. INROADS identifies interested and capable high school, college, and university students who are placed within Georgia Health Plan facilities for two to five summers with the goal of permanent placement upon graduation. In 2016, Georgia Health Plan spent approximately $66 thousand in support of this program, employing ten INROADS interns. D.3.3. Integrated Care Leadership Program Satcher Health Leadership institute at Morehouse School of Medicine Integrated Care Leadership program has an overreaching goal to promote health equity among vulnerable populations. The program is designed to develop health leaders equipped to further integration of behavioral health in primary care and building capacity among health care providers and communities in order to implement and sustain integrated care practice. The hybrid model recruits and engages new sites in guided use of online training, structured monthly leadership and capacity building activities, eligibility for high impact mini-grants with technical assistance, and mentorship from established community of practice members. E. Other Community Benefit Investments During 2016, Georgia Health Plan spent $1.7 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, illness and economic insecurity. Kaiser Permanente has therefore committed itself to protecting and improving the natural environment as a key component of our social mission to improve the health of the communities we serve. To fulfill this commitment, Kaiser Permanente maintains a governance structure for environmental stewardship that enables the organization to continuously improve its environmental performance. This structure includes clearly defined roles, responsibilities, plans and routines, and has resulted in five organization-wide focus areas that have been selected based on their ability to have the most impact on the environmental forces that shape environmental and human health. - Addressing causes of climate change - Promoting sustainable farming and food choices - Reducing, reusing, and recycling to eliminate waste - Buying products and materials that do not contain chemicals of concern - Conserving water In each of these focus areas, KFHP-GA 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 2016, key performance indicators for Kaiser Foundation Health Plan of Georgia, Inc. included: F.1.1. Improved our energy use intensity (kBtu/rentable square foot) by 2% compared to our 2010 baseline year. F.1.2. Responsibly reused or recycled over 1,500 tons of materials. F.1.3. Improved our water use intensity (gallons/rentable square foot) by 0.3% since our 2013 baseline year.
FORM 990, PART VI, LINE 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, LINE 7A	- Elect Members of The Governing Body - Kaiser Foundation Health Plan, Inc. appoints the Board of Directors (and fills vacancies and has authority to remove Directors).
FORM 990, PART VI, LINE 7B	Approval of Certain Governance Decisions The following actions of the corporation require the approval of the member. Typically the member (KFHP, Inc.) would approve actions requiring member approval and the Board of Directors of KFHP-GA also would approve or ratify the action: 1. Removal of the Chairman of the Board, CEO, or any President. The compensation of any President and other executive officers of the corporation shall be approved by the member's Compensation Committee; 2. The sale, lease, exchange, or other disposition of, the mortgage, pledge or dedication to the repayment of indebtedness (whether with or without recourse), or any other encumbrance of property of the corporation, or the acquisition of assets, whether or not in the usual or regular course of the corporation's activities, where the fair market value of such corporate property or assets being disposed of, acquired or encumbered exceeds 10% of the value of the assets of the corporation as reflected in the most recent annual or quarterly financial statements that are available on the date immediately preceding the date of the relevant transaction shall require the approval of the member; 3. Capital expenditures that exceed $25 million shall require the approval of the member; 4. The issuance of tax-exempt bonds; 5. Articles C (Member), D (Directors) and H (Amendment and Effect of Bylaws) of the Bylaws may be amended only by the member.
Form 990, Part VI, Line 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. PRIOR TO FINALIZATION, THE RETURN IS REVIEWED BY AN EXTERNAL TAX ADVISOR. 3. 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. 4. COPIES ARE THEN PROVIDED TO BOARD MEMBERS PRIOR TO FILING.
Form 990, Part VI, Line 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, Line 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, Line 18	Form 990 is available on www.guidestar.org.
Form 990, Part VI, Line 19	- Public Inspection - 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 Organizations - Individuals who are both officers and members of Boards of Directors work full time as employees as well as fulfill their board assignment. All officers work full time in their employee capacity. Full time work may require in excess of the traditional 40 hour week. Given the integrated nature of our organization, employees may provide support for various Kaiser Permanente companies. The average hours per week reported for the filing organization and related organizations was estimated.
Form 990, Part XI, Line 9	OTHER CHANGES IN NET ASSETS OR FUND BALANCES CHANGE IN PENSION AND OTHER RETIREMENT LIABILITIES $(17,076,161) GAIN/LOSS ON INVESTMENTS - TAX 472,515 GAIN/LOSS ON INVESTMENTS - BOOK 279,683 OTHER THAN TEMPORARY IMPAIRMENTS (1,130,690) ------------ TOTAL (17,454,653)
FORM 990 PART IX LINE 11G	DESCRIPTION:PURCHASED MEDICAL SERVICES TOTAL FEES:XXX-XX-XXXX
FORM 990 PART IX LINE 11G	DESCRIPTION:PURCHASED NON-MEDICAL SERVICES TOTAL FEES:39371881

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

KAISER FOUNDATION HEALTH PLAN OF GEORGIAINC

Employer identification number

58-1592076

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)KAISER FOUNDATION HEALTH PLAN INC ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 94-1340523	HEALTH CARE	CA	501(C)(3)	10	NA		No
(2)KAISER FOUNDATION HOSPITALS ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 94-1105628	HEALTH CARE	CA	501(C)(3)	3	NA		No
(3)KAISER FDN HEALTH PLAN OF COLORADO ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 84-0591617	HEALTH CARE	CO	501(C)(3)	10	KFHP INC	Yes
(4)KFHP OF THE MID-ATLANTIC STATES INC ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 52-0954463	HEALTH CARE	MD	501(C)(3)	10	KFHP INC	Yes
(5)KAISER FDN HEALTH PLAN OF THE NORTHWEST ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 93-0798039	HEALTH CARE	OR	501(C)(3)	10	KFHP INC	Yes
(6)KAISER HEALTH PLAN ASSET MANAGEMENT INC ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 94-3299124	ASSET MGMT	CA	501(C)(3)	12 - I	KFHP INC	Yes
(7)LOKAHI ASSURANCE LTD ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 91-2171891	WC Placement	HI	501(C)(3)	12 - I	KFHP INC	Yes
(8)KAISER HOSPITAL ASSET MANAGEMENT INC ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 94-3299125	ASSET MGMT	CA	501(C)(3)	12 - I	KFH	Yes
(9)CAMP BOWIE SERVICE CENTER ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 94-3299123	ADMIN	CA	501(C)(3)	12 - I	KFHP INC	Yes
(10)KAISER FDN HEALTH PLAN OF WASHINGTON ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 93-0480268	HEALTH CARE	WA	501(C)(3)	12 - I	KFHP INC	Yes
(11)KAISER HEALTH ALTERNATIVES ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 93-0954562	HEALTH CARE	OR	501(C)(3)	10	KFHP INC	Yes
(12)1800 HARRISON FOUNDATION ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 94-3317484	FINANCING	CA	501(C)(3)	12 - II	KFHP INC	Yes
(13)KAISER HOSPITAL ASSISTANCE CORPORATION ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 31-1779500	FINANCING	CA	501(C)(3)	12 - I	KFH	Yes
(14)KAISER PERMANENTE SCHOOL OF MEDICINE INC ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 81-4053028	MEDICAL EDU	CA	501(c)(3)	2	KFH	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2019

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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) NXT Cap Sr Fd ILLC 191 N Wacker Dr Ste 1200 CHICAGO,IL60606 37-1651297	INVESTMENT	DE	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	(i) Section 512(b)(13) controlled entity?
(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	Yes	No
(1) OAK TREE ASSURANCE LTD ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 03-0329760	INSURANCE	VT	NA	C CORP				No
(2) KAISER PERMANENTE INSURANCE COMPANY ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 94-3203402	INSURANCE	CA	NA	C CORP				No
(3) KAISER PROPERTIES SERVICES INC ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 94-3259432	REAL ESTATE	CA	NA	C CORP				No
(4) KAISER PERMANENTE INTERNATIONAL ONE KAISER PLAZA SUITE 15L OAKLAND,CA94612 94-3245176	CONSULTING	CA	NA	C CORP				No
(5) Kaiser Colorado Holdings One Kaiser Plaza Suite 15L Oakland,CA94612 81-4691154	Health Care	CO	NA	C Corp				No

Schedule R (Form 990) 2019

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

Yes

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

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

Yes

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

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

Yes

f Dividends from related organization(s) ............................

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

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

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

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

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

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) Kaiser Foundation Health Plan Inc	l	9,787,540	per agreement
(2) Kaiser Foundation Health Plan Inc	m	41,089,794	per agreement
(3) Kaiser Foundation Health Plan Inc	p	35,455,881	per agreement
(4) Kaiser Foundation Health Plan Inc	q	167,282,665	per agreement
(5) Kaiser Foundation Health Plan Inc	r	361,894,105	per agreement
(6) Kaiser Foundation Health Plan Inc	s	405,555,034	per agreement
(7) Kaiser Foundation Hospitals	a	15,279,546	per agreement
(8) Kaiser Foundation Hospitals	c	65,433	per agreement
(9) Kaiser Foundation Hospitals	e	36,000,000	per agreement
(10) Kaiser Foundation Hospitals	l	3,206,696	per agreement
(11) Kaiser Foundation Hospitals	m	383,337,257	per agreement
(12) Kaiser Foundation Hospitals	p	12,611,309	per agreement
(13) Camp Bowie Service Center	l	10,671,557	per agreement
(14) Camp Bowie Service Center	m	3,593,341	per agreement
(15) Camp Bowie Service Center	p	8,356,627	per agreement
(16) Camp Bowie Service Center	q	1,827,843	per agreement
(17) Kaiser Permanente Insurance Company	l	9,693,614	per agreement
(18) Kaiser Permanente Insurance Company	q	9,878,951	per agreement
(19) Lokahi Assurance LTD	l	2,076,338	per agreement
(20) Lokahi Assurance LTD	m	3,399,996	per agreement
(21) Lokahi Assurance LTD	q	1,362,224	per agreement
(22) Lokahi Assurance LTD	s	434,000	per agreement
(23) Kaiser FDN Health Plan of the Northwest	l	176,981	per agreement
(24) Kaiser FDN Health Plan of Colorado	l	579,173	per agreement
(25) Kaiser FDN Health Plan of Colorado	m	182,662	per agreement
(26) Kaiser FDN Health Plan of Colorado	p	719,110	per agreement
(27) Kaiser FDN Health Plan of Colorado	q	86,195	per agreement
(28) KFHP of the Mid-Atlantic States Inc	l	2,688,468	per agreement
(29) KFHP of the Mid-Atlantic States Inc	m	1,296,186	per agreement
(30) KFHP of the Mid-Atlantic States Inc	p	1,661,651	per agreement
(31) KFHP of the Mid-Atlantic States Inc	q	1,749,903	per agreement
(32) Oaktree Assurance Ltd	l	1,853,276	per agreement
(33) Oaktree Assurance Ltd	m	1,835,922	per agreement

Schedule R (Form 990) 2019

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

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

Schedule R (Form 990) 2019

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	5
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	2
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	3,286
6	Total number of volunteers (estimate if necessary) .............	6	162
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	90,182
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	45,570

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,573,823	1,123,474
9	Program service revenue (Part VIII, line 2g) .........	1,385,345,098	1,542,713,320
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	4,001,277	3,609,753
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	318	0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,390,920,516	1,547,446,547
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	8,573,331	3,787,811
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)	237,759,190	240,785,289
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	1,194,765,705	1,329,314,274
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,441,098,226	1,573,887,374
19	Revenue less expenses. Subtract line 18 from line 12.......	-50,177,710	-26,440,827
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	557,742,348	570,625,021
21	Total liabilities (Part X, line 26).............	1,070,858,492	1,127,213,041
22	Net assets or fund balances. Subtract line 21 from line 20.....	-513,116,144	-556,588,020

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 1,397,544,489 including grants of $ 0 ) (Revenue $ 1,539,420,754 )
	- Member health care services and medical training for care improvement - Kaiser Foundation Health Plan of Georgia, Inc. (KFHP-GA) provides medical and surgical care, including urgent care services, extended care and home health care, for its members without regards to age, sex, race, religion or national origin or the ability to pay. KFHP of Georgia educates and trains medical students and other health care professionals and promotes scientific and nursing education in order to improve care.

4b	(Code: ) (Expenses $ 28,266,208 including grants of $ 0 ) (Revenue $ 0 )
	- Charitable Care (Medical Financial Assistance and Charitable Coverage)- Kaiser Foundation Health Plan of Georgia (KFHP-GA) provides charity care to low-income vulnerable patients through the Medical Financial Assistance (MFA) and Charitable Health Coverage (CHC) Programs. KFHP-GA offers financial assistance through the MFA program to help families and individuals with a demonstrated financial need pay for all or part of the cost of emergency or medically necessary care provided in Kaiser Permanente facilities and/or by Kaiser Permanente providers. In 2016, this program assisted more than 5,000 qualifying applicants, including over 700 patients who were not covered by a KFHP-GA product. The CHC program offers regular Kaiser Foundation Health Plan membership at minimal cost to low income families who are not eligible for other public or privately sponsored coverage. More than 2,300 individuals were receiving comprehensive health care through this program at the end of 2016.

4c	(Code: ) (Expenses $ 15,107,721 including grants of $ 0 ) (Revenue $ 3,292,566 )
	- Medicaid and Other Government Sponsored Programs - Kaiser Foundation Health Plan of Georgia (KFHP-GA) is committed to improving medical care for beneficiaries of Medicaid and other government sponsored programs, not only for KFHP-GA members, but also within the communities we serve. KFHP-GA participates in the federal Medicaid program as a provider of pediatric primary and specialty care through contracts with Amerigroup, Peach State Health Plan, and WellCare Health Plans. In 2016, more than 19,500 pediatric Medicaid and Childrens Health Insurance Program (CHIP) individuals were receiving benefits under KFHP-GAs managed care program.

	(Code: ) (Expenses $ 7,924,417 including grants of $ 3,787,811 ) (Revenue $ 0 )
	SCH. O, COMMUNITY BENEFIT REPORT

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 7,924,417 including grants of $ 3,787,811 ) (Revenue $ 0 )
4e	Total program service expenses1,448,842,835

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	974,040	34,936,822	5,359,326

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	10,771
e	Government grants (contributions)		1e	55,584

f	All other contributions, gifts, grants, and similar amounts not included above		1f	1,057,119

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		1,123,474

		Business Code
2a	MEMBERS HEALTH CARE	900099	1,163,868,841	1,163,868,841
b	MEDICARE/MEDICAID PAYMENTS	900099	256,166,984	256,166,984
c	SUPPLEMENTAL CHARGE	900099	77,462,506	77,462,506
d	NON-PLAN & INDUSTRIAL	900099	5,955,469	5,865,287	90,182
e	OTHER PROGRAM SERVICES	900099	39,259,520	39,259,520
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		1,542,713,320

3 Investment income (including dividends, interest, and othersimilar amounts) ......			4,581,095			4,581,095
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)	0	0	6c
d	Net rental income or (loss).......			0
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	0	78,491,215	7a
b	Less: cost or other basis and sales expenses	498,827	78,963,730	7b
c	Gain or (loss)	-498,827	-472,515	7c
d	Net gain or (loss).........			-971,342			-971,342
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a	0
b	Less: direct expenses ...		8b	0
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a	0
b	Less: direct expenses ...		9b	0
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
			10a	0
b	Less: cost of goods sold ..		10b	0
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			0
12	Total revenue. See instructions.....			1,547,446,547	1,542,623,138	90,182	3,609,753

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	3,787,811	3,787,811
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. 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 ...........	51,212		51,212
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........	181,441,467	164,394,012	17,047,455
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	19,059,711	19,059,711
9	Other employee benefits .......	27,175,141	21,626,111	5,549,030
10	Payroll taxes ...........	13,057,758	13,057,758
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	211,126		211,126
c	Accounting ...........	708,950		708,950
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	316,548		316,548
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	269,324,000	252,599,473	16,724,527
12	Advertising and promotion ....	7,241,968	375,536	6,866,432
13	Office expenses .......	4,082,288	3,586,103	496,185
14	Information technology ......	89,269,471	74,468,268	14,801,203
15	Royalties ..	0
16	Occupancy ...........	13,149,375	13,149,375
17	Travel ............	1,537,279	1,198,371	338,908
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	575,289		575,289
20	Interest ...........	16,275,599	16,275,599
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	22,032,460	22,032,460
23	Insurance ...	4,245,705	4,245,705
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	BASIC CONTRACTUAL PAYMENTS	617,685,540	617,685,540
b	SUPPLIES-MEDICAL,OFFICE	200,239,808	185,407,951	14,831,857
c	PREMIUM DEFICIENCY RESERVE	-28,459,409	-28,459,409
d	INTER-REGIONAL CHARGES	60,940,380	50,271,077	10,669,303
e	All other expenses	49,937,897	14,081,383	35,856,514
25	Total functional expenses. Add lines 1 through 24e	1,573,887,374	1,448,842,835	125,044,539	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			0	1	0
2	Savings and temporary cash investments .........			1,192,501	2	1,545,534
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			48,087,936	4	65,191,990
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........			0	7	0
8	Inventories for sale or use ............			15,090,386	8	15,601,611
9	Prepaid expenses and deferred charges ......			1,124,131	9	1,425,208
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	448,596,825
b	Less: accumulated depreciation	10b	228,387,102	231,825,272	10c	220,209,723
11	Investments—publicly traded securities .			234,879,544	11	238,766,528
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 ...........			25,542,578	15	27,884,427
16	Total assets. Add lines 1 through 15 (must equal line 33)...			557,742,348	16	570,625,021

17	Accounts payable and accrued expenses .....	104,737,036	17	137,066,297
18	Grants payable ...	0	18	0
19	Deferred revenue .........	14,887,854	19	16,762,110
20	Tax-exempt bond liabilities .........	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		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	951,233,602	25	973,384,634
26	Total liabilities. Add lines 17 through 25..	1,070,858,492	26	1,127,213,041

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........		27
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....	8,135,623	29	8,135,623
30	Paid-in or capital surplus, or land, building or equipment fund ...	0	30	0
31	Retained earnings, endowment, accumulated income, or other funds	-521,251,767	31	-564,723,643
32	Total net assets or fund balances ...........	-513,116,144	32	-556,588,020
33	Total liabilities and net assets/fund balances ........	557,742,348	33	570,625,021