Form990
Click to see attachment
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 01-01-2018 , and ending 12-31-2018
BCheck if applicable:
CName of organization
KAISER FOUNDATION HEALTH PLAN OF GEORGIAINC
 
% CHIEF ACCOUNTING OFFICER
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
ONE KAISER PLAZA SUITE 15L
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
OAKLAND, CA94612
D Employer identification number

58-1592076
E Telephone number

G Gross receipts $ 2,272,838,055
F Name and address of principal officer:
James Simpson
ONE KAISER PLAZA SUITE 15L
OAKLAND,CA94612
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.kp.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1985
M State of legal domicile: GA
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: TO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 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 2018 (Part V, line 2a) ...... 5 4,277
6 Total number of volunteers (estimate if necessary) ............. 6 101
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 224,239
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 123,601
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 436,960 1,092,598
9 Program service revenue (Part VIII, line 2g) ......... 1,750,565,061 2,160,138,763
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 5,085,131 7,385,338
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 0 0
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 1,756,087,152 2,168,616,699
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 7,101,306 12,949,040
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) 262,128,952 308,378,985
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 1,493,058,182 2,068,986,995
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,762,288,440 2,390,315,020
19 Revenue less expenses. Subtract line 18 from line 12....... -6,201,288 -221,698,321
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 562,031,363 835,995,527
21 Total liabilities (Part X, line 26)............. 1,149,505,163 1,575,943,213
22 Net assets or fund balances. Subtract line 21 from line 20..... -587,473,800 -739,947,686
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2018)
Form 990 (2018)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: TO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 2,142,009,799 including grants of $ 34,176 ) (Revenue $ 2,156,169,487 )
- 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 $ 37,958,641 including grants of $ 0 ) (Revenue $ 0 )
- Charity 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 2018, THIS PROGRAM ASSISTED OVER 53,000 PATIENTS THROUGH FINANCIAL ASSISTANCE. 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. APPROXIMATELY 2,000 INDIVIDUALS WERE RECEIVING COMPREHENSIVE HEALTH CARE THROUGH THIS PROGRAM AT THE END OF 2018.
4c (Code:   ) (Expenses $ 14,247,835 including grants of $ 0 ) (Revenue $ 3,969,276 )
- 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. AT THE END OF 2018, MORE THAN 24,000 INDIVIDUALS WERE RECEIVING BENEFITS THROUGH KFHP-GA'S MANAGED CARE CONTRACTS.
(Code:   ) (Expenses $ 18,156,200 including grants of $ 12,914,864 ) (Revenue $ 0 )
SCH. O, COMMUNITY BENEFIT REPORT
4d Other program services (Describe in Schedule O.)
(Expenses $ 18,156,200 including grants of $ 12,914,864 ) (Revenue $ 0 )
4e Total program service expensesMediumBullet2,212,372,475
Form 990 (2018)
Form 990 (2018)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment..............
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment.................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment..................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part IIIClick to see attachment.............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
 
No
Form 990 (2018)
Form 990 (2018)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I............
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L,
Part IV
........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV.....................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I.
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II...........
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
3,606
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2018)
Form 990 (2018)
Page 5
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
4,277
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? .........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? If "Yes," see instructions and file Form 4720, Schedule N .....
15
Yes
 
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income?
If "Yes," complete Form 4720, Schedule O ................
16
 
No
Form 990 (2018)
Form 990 (2018)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
5
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
2
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
GA
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletCHIEF ACCOUNTING OFFICERONE KAISER PLAZA 15L   OAKLAND,CA94612 (510) 271-6611
Form 990 (2018)
Form 990 (2018)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Gregory Adams......................................................................
EVP, Group President
4.0
.................
46.0
X   X       0 9,082,242 1,144,302
(2) John W Jackson......................................................................
Director
2.5
.................
0.0
X           39,212 0 0
(3) Jeffrey P Koplan MD MPH......................................................................
Director
1.0
.................
0.0
X           19,000 0 0
(4) Kathryn Lancaster......................................................................
EVP & CFO
3.5
.................
46.5
X   X       0 3,221,105 353,313
(5) James Simpson......................................................................
Regional President - GA
45.0
.................
5.0
X   X       0 1,189,166 231,306
(6) Kristin Bear......................................................................
Assistant Secretary
4.0
.................
46.0
    X       0 319,457 24,425
(7) Kirkland McGhee......................................................................
Assistant Secretary
50.0
.................
0.0
    X       0 354,474 73,636
(8) Thomas Meier......................................................................
SVP, Corporate Treasurer
1.5
.................
48.5
    X       0 1,211,947 41,466
(9) Donald Orndoff......................................................................
SVP, NFS
4.0
.................
46.0
    X       0 1,147,552 202,084
(10) Arthur Southam......................................................................
EVP, Health Plan Operations
4.0
.................
46.0
    X       0 3,370,942 573,089
(11) Bernard Tyson......................................................................
Chairman & CEO
3.5
.................
46.5
    X       0 15,709,853 2,173,780
(12) Alfonse Upshaw......................................................................
SVP,Corporate Controller & CAO
3.5
.................
46.5
    X       0 813,644 128,411
(13) Cherita White......................................................................
Assistant Secretary
50.0
.................
0.0
    X       0 137,209 40,526
(14) Hong-Sze Yu......................................................................
VP, Brd & Corp Gov & Asst Secy
3.5
.................
46.5
    X       0 361,334 86,046
(15) Mark Zemelman......................................................................
SVP, General Counsel & Secy
2.0
.................
48.0
    X       0 2,058,532 22,057
(16) James Cullinan......................................................................
VP, MSBD - GA
50.0
.................
0.0
      X     0 625,449 110,143
(17) Craig Faerber......................................................................
VP, CFO - Georgia
50.0
.................
0.0
      X     0 726,075 133,383
Form 990 (2018)
Form 990 (2018)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (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)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Jonna Kirkwood........................................................................
VP, COO - GA
50.0
.......................0.0
      X     0 581,608 61,401
(19) Theresa Kurtinaitis........................................................................
VP, Quality - GA
50.0
.......................0.0
      X     0 306,605 117,323
(20) Michael Wathen........................................................................
VP, HP Services & Admin - GA
50.0
.......................0.0
      X     0 385,641 68,405
(21) Dawn Bading........................................................................
VP, Talent Acquisition
50.0
.......................0.0
        X   0 511,899 122,027
(22) Andrew Stephen Bradlyn........................................................................
Exec Dir, Ctr for Clinical & O
50.0
.......................0.0
        X   0 297,107 83,609
(23) Michael D Brown........................................................................
VP, HR - Georgia
50.0
.......................0.0
        X   0 352,909 96,316
(24) Deborah Friberg........................................................................
SVP, Area Mgr - Central Valley
50.0
.......................0.0
        X   0 379,072 93,187
(25) Beverly Thomas........................................................................
VP, Community & Public Affairs
50.0
.......................0.0
        X   0 434,681 50,938
(26) Julie Miller-Phipps........................................................................
Regional President - SCAL
0.0
.......................50.0
          X 0 2,024,517 -35,059
(27) Jacqueline Sellers........................................................................
Assistant Secretary
0.0
.......................50.0
          X 0 300,332 35,262
(28) Pamela Hara........................................................................
VP Quality/Risk Mgt & Pop Hlth
0.0
.......................0.0
          X 0 149,875 0




1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 58,212 46,053,227 6,031,376
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet521
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
SOUTHEAST PERMANENTE MEDICAL GROUP,
3495 PIEDMONT ROAD NE
ATLANTA,GA30305
MEDICAL SERVICES 449,025,272
NORTHSIDE HOSPITAL,
1000 Johnson Ferry Rd
ATLANTA,GA30342
MEDICAL SERVICES 192,249,814
PIEDMONT HOSPITAL INC,
1968 Peachtree Road NW
ATLANTA,GA30309
MEDICAL SERVICES 70,805,319
GRADY MEMORIAL HOSPITAL,
PO BOX 930704
ATLANTA,GA31198
MEDICAL SERVICES 30,488,428
WELLSTAR KENNESTONE HOSPITAL,
677 CHURCH STREET
MARIETTA,GA30060
MEDICAL SERVICES 27,214,573
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet315
Form 990 (2018)
Form 990 (2018)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f 1,092,598
g Noncash contributions included in lines 1a - 1f:$  
h Total. Add lines 1a-1f.......MediumBullet 1,092,598
 Program Service RevenueAmt Business Code
2a MEMBERS HEALTH CARE 900099 1,709,989,083 1,709,989,083    
b MEDICARE/MEDICAID PAYMENTS 900099 298,247,279 298,247,279    
c SUPPL CHARGE/PHARM 900099 100,782,735 100,782,735    
d NON-PLAN & INDUSTRIAL 900099 3,306,866 3,082,627 224,239  
e OTHER PROGRAM SERVICES 900099 47,812,800 47,812,800    
f All other program service revenue.        
g Total. Add lines 2a–2f ....MediumBullet 2,160,138,763
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 8,174,504     8,174,504
4 Income from investment of tax-exempt bond proceedsMediumBullet 0      
5 Royalties...........MediumBullet 0      
(ii) Personal (i) Real
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss) 0 0
d Net rental income or (loss)......MediumBullet 0      
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 159 103,432,031
b Less: cost or other basis and sales expenses 101,230 104,120,126
c Gain or (loss) -101,071 -688,095
d Net gain or (loss).....MediumBullet -789,166     -789,166
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
a 0
b Less: direct expenses ...b 0
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a 0
b Less: direct expenses ...b 0
c Net income or (loss) from gaming activities..MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances ..
a 0
b Less: cost of goods sold ..b 0
c Net income or (loss) from sales of inventory..MediumBullet 0      
Business Code Miscellaneous Revenue
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 0
12 Total revenue. See Instructions......MediumBullet 2,168,616,699 2,159,914,524 224,239 7,385,338
Form 990 (2018)
Form 990 (2018)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 12,949,040 12,949,040
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, line 15 and 16. 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 58,212   58,212  
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 236,997,096 221,010,707 15,986,389 0
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 21,329,061 21,329,061    
9 Other employee benefits ....... 31,672,333 26,571,955 5,100,378  
10 Payroll taxes ........... 18,322,283 18,322,283    
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 3,836   3,836  
c Accounting ........... 896,004   896,004  
d Lobbying ........... 0      
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 378,702   378,702  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 443,873,641 416,670,859 27,202,782 0
12 Advertising and promotion .... 8,264,862 440,101 7,824,761  
13 Office expenses ....... 5,396,955 4,313,245 1,083,710  
14 Information technology ...... 100,266,311 69,071,759 31,194,552  
15 Royalties .. 0      
16 Occupancy ........... 19,528,057 19,528,057    
17 Travel ............ 1,647,055 1,213,151 433,904  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 0      
19 Conferences, conventions, and meetings .... 760,907   760,907  
20 Interest ........... 24,810,541 24,810,541    
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization .. 25,890,902 25,890,902    
23 Insurance ... 5,356,194 5,356,194    
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 863,942,428 863,942,428    
b SUPPLIES-MEDICAL,OFFICE 293,112,403 261,643,292 31,469,111  
c INTER-REGIONAL CHARGES 116,504,538 110,732,345 5,772,193  
d PREMIUM DEFICIENCY RESERVE 94,191,383 94,191,383    
e All other expenses 64,162,276 14,385,172 49,777,104  
25 Total functional expenses. Add lines 1 through 24e 2,390,315,020 2,212,372,475 177,942,545 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2018)
Form 990 (2018)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 0 1 0
2 Savings and temporary cash investments ......... 2,033,033 2 5,440,478
3 Pledges and grants receivable, net ...... 0 3 0
4 Accounts receivable, net ............. 55,984,092 4 69,348,124
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
0 6 0
7 Notes and loans receivable, net .... 0 7 0
8 Inventories for sale or use ........ 13,796,662 8 11,562,698
9 Prepaid expenses and deferred charges ...... 1,232,641 9 731,328
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 504,347,653
b Less: accumulated depreciation 10b 268,625,749 214,582,229 10c 235,721,904
11 Investments—publicly traded securities . 241,578,915 11 426,170,389
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 ........... 32,823,791 15 87,020,606
16 Total assets. Add lines 1 through 15 (must equal line 34)... 562,031,363 16 835,995,527
Liabilities 17 Accounts payable and accrued expenses ..... 139,371,235 17 236,313,908
18 Grants payable ... 0 18 0
19 Deferred revenue ......... 25,796,935 19 24,248,720
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 current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.. 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .. 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 984,336,993 25 1,315,380,585
26 Total liabilities. Add lines 17 through 25.. 1,149,505,163 26 1,575,943,213
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets   27  
28 Temporarily restricted net assets ...........   28  
29 Permanently restricted net assets   29  
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ..... 8,135,623 30 58,135,623
31 Paid-in or capital surplus, or land, building or equipment fund ... 0 31 0
32 Retained earnings, endowment, accumulated income, or other funds -595,609,423 32 -798,083,309
33 Total net assets or fund balances ........... -587,473,800 33 -739,947,686
34 Total liabilities and net assets/fund balances ........ 562,031,363 34 835,995,527
Form 990 (2018)
Form 990 (2018)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
2,168,616,699
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
2,390,315,020
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-221,698,321
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
-587,473,800
5
Net unrealized gains (losses) on investments ...............
5
2,005,095
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
67,219,340
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
-739,947,686
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2018)
Form 990 (2018)
Additional Data


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

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
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.)
1
2
3
4
5
6
7
8
9

10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (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) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (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  
12
12
 
13
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
14
14
 
15
15
 
16a
b
17a
b
18
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) 2018

Schedule A (Form 990 or 990-EZ) 2018
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) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . 1,422,285 1,573,823 1,123,474 436,960 1,092,598 5,649,140
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 1,273,100,973 1,385,080,975 1,542,623,138 1,750,461,756 2,159,914,524 8,111,181,366
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 1,274,523,258 1,386,654,798 1,543,746,612 1,750,898,716 2,161,007,122 8,116,830,506
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.) 8,116,830,506
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (f) Total
9 Amounts from line 6... 1,274,523,258 1,386,654,798 1,543,746,612 1,750,898,716 2,161,007,122 8,116,830,506
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. 3,508,275 3,960,516 4,581,095 5,143,808 8,174,504 25,368,198
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. 7,347 31,809 30,076 36,677 97,645 203,554
c Add lines 10a and 10b. 3,515,622 3,992,325 4,611,171 5,180,485 8,272,149 25,571,752
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.).. 1,278,038,880 1,390,647,123 1,548,357,783 1,756,079,201 2,169,279,271 8,142,402,258
14
Section C. Computation of Public Support Percentage
15
15
99.686 %
16
16
99.723 %
Section D. Computation of Investment Income Percentage
17
17
0.314 %
18
18
0.277 %
19a
b
20
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
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
No
1
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.
1
 
 
2
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).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
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.
3b
 
 
c
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.
3c
 
 
4a
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.
4a
 
 
b
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.
4b
 
 
c
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.
4c
 
 
5a
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).
5a
 
 
b
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?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
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.
6
 
 
7
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) .
7
 
 
8
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).
8
 
 
9a
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.
9a
 
 
b
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.
9b
 
 
c
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.
9c
 
 
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
 
 
b
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) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
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
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
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
No
1
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.
1
 
 
2
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.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
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).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
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?
1
 
 
2
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).
2
 
 
3
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.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
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.
2a
 
 
b
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.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
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.
3a
 
 
b
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.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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  
7
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
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 2018 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-2018
(iii)
Distributable
Amount for 2018
1 Distributable amount for 2018 from Section C, line
6
 
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2018:
a From 2013.......  
b From 2014.......  
c From 2015.......  
d From 2016.......  
e From 2017.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2018 distributable amount  
i Carryover from 2013 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2018 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2018 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2018, 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 2018. 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 2019. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2014......  
b Excess from 2015.....  
c Excess from 2016.....  
d Excess from 2017.....  
e Excess from 2018.....  
Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018
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) 2018


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
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






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution. An organization that 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) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2
Name of organization
KAISER FOUNDATION HEALTH PLAN OF GEORGIAINC
 
Employer identification number
58-1592076
Part I
Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


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

$  


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

$  


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

$  


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

$  


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

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
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) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
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 $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Additional Data


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

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

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

SchCMd Bullet Complete if the organization is described below. SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
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.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

2
Political campaign activity expenditures (see instructions) ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities (see instructions) ..................................................................
 

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

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

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
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) 2018

Schedule C (Form 990 or 990-EZ) 2018
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 Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ...............................    
c Total lobbying expenditures (add lines 1a and 1b) ...................................................................    
d Other exempt purpose expenditures ........................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2015 (b) 2016 (c) 2017 (d) 2018 (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) 2018


Schedule C (Form 990 or 990-EZ) 2018
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)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
Yes
 
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
Yes
 
134,400
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
Yes
 
7,265
i
Other activities? ...................................................................................................................
Yes
 
7,623
j
Total. Add lines 1c through 1i ....................................................................................................
149,288
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
No
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
Part IV
Supplemental Information
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 ("KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC." AKA "KFHP GA") IS A MEMBER OF THE KAISER PERMANENTE MEDICAL CARE PROGRAM (KP) 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), KFHP GA HAS A POLICY PROHIBITING ANY OF KFHP GA'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. KFHP GA 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. KP EMPLOYS INDIVIDUALS, INCLUDING ONE OR MORE REGISTERED LOBBYISTS AND/OR MAY RETAIN ONE OR MORE PROFESSIONAL CONSULTANTS TO REPRESENT KFHP GA'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 KP'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 KP, 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 KFHP GA 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 KFHP GA. INDIVIDUALS APPEARING AT SUCH HEARINGS AND MEETINGS FOR AND ON BEHALF OF KFHP GA OFTEN ARE REPRESENTING THE INTERESTS OF COMMON INTEREST GROUPS AS WELL AS THE INTERESTS OF THE MEMBERS AND PATIENTS OF KFHP GA. 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) 2018


Additional Data


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SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet 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 the latest information.
OMB No. 1545-0047
2018
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 ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
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.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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) 2018

Schedule D (Form 990) 2018
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part 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  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
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 ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations .................
3a(i)
 
 
(ii) related organizations .................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
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 .....   30,422,363 30,422,363
b Buildings ....   287,892,232 132,966,078 154,926,154
c Leasehold improvements   43,920,661 31,880,541 12,040,120
d Equipment ....   131,740,041 102,080,172 29,659,869
e Other .....   10,372,356 1,698,958 8,673,398
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 235,721,904
Schedule D (Form 990) 2018

Schedule D (Form 990) 2018
Page 3
Part VII
Investments—Other 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
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program 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
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
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
(1) STATUTORY DEPOSITS 105,476
(2) OTHER ASSETS 24,289
(3) DUE FROM AFFILIATES 38,685,833
(4) OTHER ACQUIRED INTANGIBLE 48,205,008
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 87,020,606
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
PENSION PLAN PAYABLE 83,664,876
SELF-INSURED RISKS 47,103,482
DUE TO AFFILIATED ORGANIZATION 61,030,357
NOTE PAYABLE TO AFFILIATES 1,014,365,996
OTHER LIABILITIES 15,288,842
PREMIUM DEFICIENCY RESERVES 93,927,032
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 1,315,380,585
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) 2018

Schedule D (Form 990) 2018
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) 2018


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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
2018
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
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to 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 (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
noncash assistance
(h) Purpose of grant
or assistance
(1) Advantage Behavioral Health Systems
250 N Ave
Athens,GA30601
58-2112427 Govt/Pub Agcy 75,000       Project Support
(2) American Heart Association Inc
10 Glenlake Pkwy S Twr
Atlanta,GA30328
13-5613797 501(c)(3) 27,000       Event Support\Annual Fundraiser
(3) ARCS Fdn Inc
1085 Brookhaven Square
Atlanta,GA30319
58-2004368 501(c)(3) 10,000       Project Support
(4) Atlanta Community Food Bank Inc
732 Joseph E Lowery Blvd
Atlanta,GA30318
58-1376648 501(c)(3) 250,000       Project Support
(5) Atlanta Neighborhood Dvlp Partnership
229 Peachtree St Ste 706
Atlanta,GA30303
58-1946633 501(c)(3) 250,000       Project Support
(6) Atlanta Volunteer Lawyers Fdn Inc
235 Peachtree St Ste 1750
Atlanta,GA30303
58-1364400 501(c)(3) 85,000       Project Support
(7) Atlanta Women's Fdn Inc
3355 Lenox Rd Ste 850
Atlanta,GA30326
58-2389721 501(c)(3) 123,500       Event Support\Luncheon
(8) Bearings Bike Shop
982 Murphy Ave SW
Atlanta,GA30310
45-4335893 501(c)(3) 25,000       Project Support
(9) BF INC
64 Edwin Place NW
Atlanta,GA30318
43-1988942 501(c)(3) 40,000       Project Support
(10) Big Bro Big Sis Of Metro Atlanta Inc
1382 Peachtree St NE
Atlanta,GA30309
58-0861895 501(c)(3) 45,000       Project Support
(11) Boys & Girls Clubs of Metro Atlanta Inc
1275 Peachtree St NE
Atlanta,GA30309
58-0566123 501(c)(3) 30,000       Project Support
(12) Camp Kudzu Inc
5885 Glenridge Dr
Atlanta,GA30328
58-2449646 501(c)(3) 50,000       Project Support
(13) Caring Works Inc
2785 Lawrenceville Hwy
Decatur,GA30033
56-2370081 501(c)(3) 50,000       Project Support
(14) Catholic Charities Of Atlanta Inc
2401 Lake Park Dr SE
Smyrna,GA30080
58-1097003 501(c)(3) 78,500       Project Support
(15) Chattahoochee Nature Center Inc
9135 Willeo Rd
Roswell,GA30075
58-1275604 501(c)(3) 30,000       Project Support
(16) Children's Museum of Atlanta Inc
275 Centennial Olympic Pk
Atlanta,GA30313
58-1785484 501(c)(3) 85,000       Project Support
(17) CHRIS Kids Inc
1017 Fayetteville Rd SE
Atlanta,GA30316
58-1430183 501(c)(3) 250,000       Project Support
(18) Clayton State University Fdn Inc
2000 Clayton State Blvd
Morrow,GA30260
23-7419285 501(c)(3) 95,000       Scholarships
(19) Cobb County Board of Health
1650 County Svcs Pkwy
Marietta,GA30008
58-1517015 Govt/Pub Agcy 75,564       Project Support
(20) Communities In Schools Of Georgia Inc
260 Peachtree St NW
Atlanta,GA30303
58-1912923 501(c)(3) 40,000       Project Support
(21) Community Advanced Practice Nurses Inc
173 Blvd NE
Atlanta,GA30312
58-2435328 501(c)(3) 60,000       Project Support
(22) Corporate Volunteer Council
600 Means St NW Ste 100
Atlanta,GA30318
58-2054790 501(c)(3) 16,500       Project Support
(23) Covenant House Georgia Inc
1559 Johnson Rd NW
Atlanta,GA30318
13-3523561 501(c)(3) 85,000       Project Support
(24) DeKalb County Board of Health
445 Winn Way
Decatur,GA30030
58-1417092 Govt/Pub Agcy 85,000       Project Support
(25) Emory University
201 Dowman Dr
Atlanta,GA30322
58-1537752 501(c)(3) 4,000,000       Project Support
(26) Families First Inc
80 Lowery Blvd
Atlanta,GA30314
58-1054331 501(c)(3) 74,050       Event Support\Annual Fundraiser
(27) Fayette Care Clinic Inc
1260 Hwy 54 W
Fayetteville,GA30214
20-0314897 501(c)(3) 50,000       Project Support
(28) Fernbank Inc
767 Clifton Rd NE
Atlanta,GA30307
58-6028607 501(c)(3) 8,500       Event Support\Annual Fundraiser
(29) First Step Staffing
236 Auburn Ave Ste 203
Atlanta,GA30303
20-8038859 501(c)(3) 85,000       Project Support
(30) Future Fdn
1892 Washington Rd
East Point,GA30344
58-2636418 501(c)(3) 50,000       Project Support
(31) GA Camp for Adolsc Pwr and Potential Inc
1718 Peachtree St Ste 465
Atlanta,GA30309
31-1520709 501(c)(3) 95,000       Project Support
(32) GA State University Research Fdn Inc
394 S Milledge Ave
Athens,GA30602
58-1845423 501(c)(3) 125,000       Project Support
(33) Georgia Gwinnett College Fdn Inc
1000 Uni Ctr Lane
Lawrenceville,GA30043
20-5107997 501(c)(3) 80,000       Scholarships
(34) Georgia Health News Inc
2635 Rangewood Court
Atlanta,GA30345
27-3543332 501(c)(3) 19,000       Project Support
(35) Georgia Lions Lighthouse Fdn Inc
5582 Peachtree Rd
Chamblee,GA30341
58-0548732 501(c)(3) 75,000       Project Support
(36) Georgia Organics Inc
200 Ottley Dr NE Ste A
Atlanta,GA30324
58-2345310 501(c)(3) 75,000       Project Support
(37) Georgia State University
PO BOX 3999
Atlanta,GA30302
58-6002050 501(c)(3) 74,346       Research grants
(38) Georgia State University Fdn Inc
141 Decatur St
Atlanta,GA30302
58-6033185 501(c)(3) 96,300       Event Support\Luncheon
(39) Georgia Watch
55 Marietta St NW
Atlanta,GA30303
16-1639971 501(c)(3) 30,000       Event Support\Annual Fundraiser
(40) Girls Incorporated of Greater Atlanta
1401 Peachtree St Ste 500
Atlanta,GA30309
58-1276804 501(c)(3) 20,000       Project Support
(41) Good News Clinics Inc
810 Pine St
Gainesville,GA30501
58-2058853 501(c)(3) 70,000       Project Support
(42) Good Samaritan Health Center of Cobb Inc
1605 Roberta Dr SW
Marietta,GA30008
32-0045238 501(c)(3) 85,000       Project Support
(43) Good Samaritan Health Center Inc
1015 Donald Lee H Pkwy
Atlanta,GA30318
58-2373395 501(c)(3) 85,000       Project Support
(44) Good Samaritan Hlth and Wellness Ctr Inc
175 Samaritan Dr
Jasper,GA30143
58-2576315 501(c)(3) 85,000       Project Support
(45) Good Shepherd Clinic Inc
6392 Murphy Dr
Morrow,GA30260
58-2578581 501(c)(3) 30,000       Project Support
(46) Goodwill Of North Georgia Inc
235 Peachtree St N Twr
Atlanta,GA30303
20-8351046 501(c)(3) 75,000       Project Support
(47) Grove Park Fdn Inc
1562 Donald Lee H Pkwy
Atlanta,GA30318
82-1913260 501(c)(3) 500,000       Project Support
(48) Gwinnett Tech Fdn
5150 Sugarloaf Pkwy
Lawrenceville,GA30043
58-2106879 501(c)(3) 80,000       Scholarships
(49) Hands of Hope Clinic Inc
1010 Hospital Dr
Stockbridge,GA30281
42-1591970 501(c)(3) 50,000       Project Support
(50) Hands on Atlanta Inc
600 Means St Ste 100
Atlanta,GA30318
58-1861026 501(c)(3) 55,000       Project Support
(51) Harvard Debate
490 Adams Mail Ctr
Cambridge,MA02138
04-2597463 501(c)(3) 20,500       Project Support
(52) Heritage Fund of At Medical Assn Inc
101 Edgewood Ave NE
Atlanta,GA30303
58-2372394 501(c)(3) 30,000       Event Support\Annual Fundraiser
(53) Hillside Inc
690 Courtenay Dr NE
Atlanta,GA30306
58-0603148 501(c)(3) 75,000       Project Support
(54) HIVAIDS Emp Rrc Ctr for Young Women Inc
230 Peachtree St NW
Atlanta,GA30303
56-2587827 501(c)(3) 75,000       Project Support
(55) Hosea Feed the Hungry and Homeless Inc
1035 Donnelly Ave SW
Atlanta,GA30310
58-1340903 501(c)(3) 50,000       Project Support
(56) International Rescue Committee Inc
2305 Parklake Dr NE
Atlanta,GA30345
13-5660870 501(c)(3) 50,000       Project Support
(57) It's The Journey Inc
270 Carpenter Dr
Atlanta,GA30328
47-0897591 501(c)(3) 32,500       Event Support\Annual Fundraiser
(58) JDRF International
26 BRdway 15th Flr
New York,NY10004
23-1907729 501(c)(3) 5,500       Event Support\Annual Fundraiser
(59) Jerusalem House Inc
17 Executive Park Dr NE
Atlanta,GA30329
58-1829807 501(c)(3) 75,000       Project Support
(60) Jewish Family & Career Services Inc
4549 Chamblee Dunwoody Rd
Atlanta,GA30338
58-1479212 501(c)(3) 75,000       Project Support
(61) Junior Achievement of Georgia Inc
460 Abernathy Rd NE
Atlanta,GA30328
58-0598050 501(c)(3) 40,000       Project Support
(62) Kate's Club INC
1190 W Druid Hills DR NE
Atlanta,GA30329
16-1646487 501(c)(3) 50,000       Project Support
(63) Kennesaw State University Fdn Inc
1000 Chastain Rd
Kennesaw,GA30066
23-7034345 501(c)(3) 80,000       Scholarships
(64) Latin American Association
2750 Buford Hwy
Atlanta,GA30324
58-1237316 501(c)(3) 39,050       Project Support
(65) Leadership DeKalb Inc
315 W Ponce de Leon Ave
Decatur,GA30030
58-2131661 501(c)(3) 7,500       Event Support\Workforce/Knowledge Dissemination
(66) Life Tools Community Dvlp Corporation
5357 Chapel Hill Rd
Douglasville,GA30135
27-0070164 501(c)(3) 15,000       Project Support
(67) Living Room Inc
50 Hurt Plaza Ste 1200
Atlanta,GA30303
31-1616463 501(c)(3) 35,000       Project Support
(68) Lovett School
4075 Paces Ferry Rd NW
Atlanta,GA30327
58-0619038 501(c)(3) 30,000       Project Support
(69) Lutheran Services Of Georgia Inc
230 Peachtree St
Atlanta,GA30303
58-1535692 501(c)(3) 40,000       Project Support
(70) MAP International Inc
4700 Glynco Pkwy
Brunswick,GA31525
36-2586390 501(c)(3) 9,000       Event Support\Awards Ceremony
(71) March of Dimes Fdn
1776 Peachtree St
Atlanta,GA30309
13-1846366 501(c)(3) 17,650       Project Support
(72) Mercy Health Center Inc
700 Oglethorpe Ave C7
Athens,GA30606
58-2603523 501(c)(3) 50,000       Project Support
(73) Metro Atlanta Recovery Residences Inc
2815 Clearview Place
Doraville,GA30340
23-7442673 501(c)(3) 50,000       Project Support
(74) Metropolitan Counseling Services Inc
2801 Buford Hwy
Atlanta,GA30329
58-2236480 501(c)(3) 19,250       Project Support
(75) MLK Jr Ctr for Nonviolent Social Change
449 Auburn Ave
Atlanta,GA30212
58-1030989 501(c)(3) 13,500       Event Support\Annual Fundraiser
(76) Morehouse College
830 Westview Dr SW
Atlanta,GA30314
58-0566205 501(c)(3) 49,400       Project Support
(77) Morehouse School of Medicine
720 Westview Dr SW
Atlanta,GA30310
58-1438873 501(c)(3) 509,350       Project Support
(78) MUST Ministries Inc
1407 Cobb Pkwy N
Marietta,GA30061
58-2034725 501(c)(3) 50,000       Project Support
(79) Odyssey Family Counseling Center Corp
1919 John Wesley Ave
College Park,GA30337
58-1295404 501(c)(3) 50,000       Project Support
(80) Palmetto Health Council Inc
643 Main St
Palmetto,GA30268
58-1307597 501(c)(3) 85,000       Project Support
(81) Park Pride Atlanta
236 Peachtree St
Atlanta,GA30303
58-1883895 501(c)(3) 89,000       Event Support\Annual Fundraiser
(82) Pedestrians Edu Drivers on Safety Inc
1389 Peachtree St NE
Atlanta,GA30309
58-2267503 501(c)(3) 30,000       Project Support
(83) Piedmont Park Conservancy Inc
400 Park Dr
Atlanta,GA30306
58-1551369 501(c)(3) 94,300       Event Support\Luncheon
(84) Playworks Education Energized Georgia
PO Box 7040
Atlanta,GA30357
94-3251867 501(c)(3) 95,000       Project Support
(85) Positive Impact Health Centers
3075 Breckinridge Blvd
Duluth,GA30096
58-1763324 501(c)(3) 75,000       Project Support
(86) Premier Academy Inc
399 Macedonia Rd
Atlanta,GA30354
58-1169016 501(c)(3) 50,000       Project Support
(87) Project Open Hand-Atlanta Inc
181 Armour Dr NE
Atlanta,GA30324
58-1816778 501(c)(3) 85,000       Project Support
(88) Purpose Built Schools
1670 Benjamin W Bickers Dr
Atlan,GA30315
81-1114844 501(c)(3) 50,000       Project Support
(89) Quest Community Dvlp Org
878 Rock St NW
Atlanta,GA30314
58-2634738 501(c)(3) 60,000       Project Support
(90) Rainbow Village Inc
3427 Duluth Hwy 120
Duluth,GA30096
58-2181183 501(c)(3) 15,000       Project Support
(91) Richmont Graduate University
1900 The Exchange
Atlanta,GA30339
62-0789275 501(c)(3) 30,000       Project Support
(92) Robert W Woodruff Arts Center Inc
1280 Peachtree St NE
Atlanta,GA30309
58-0633971 501(c)(3) 99,000       Project Support
(93) SafePath Children's Advocacy Center Inc
736 Whitlock Ave
Marietta,GA30064
58-1662987 501(c)(3) 30,000       Project Support
(94) Saint Joseph's Mercy Care Services Inc
424 Decatur St SE
Atlanta,GA30312
58-1752700 501(c)(3) 50,000       Project Support
(95) Senior Citizen Svcs of Metrop At Inc
1705 Commerce Dr NW
Atlanta,GA30318
58-0960309 501(c)(3) 50,000       Project Support
(96) Solomons Temple Fdn Inc
2836 Springdale Rd SW
Atlanta,GA30315
81-0983784 501(c)(3) 35,000       Project Support
(97) Someone Cares Inc Of Atlanta
1950 Spectrum Circle
Marietta,GA30067
41-2025888 501(c)(3) 35,000       Project Support
(98) Southeastern Council
100 Peachtree St
Atlanta,GA30303
56-0995114 501(c)(3) 20,600       Project Support
(99) Susan G Komen Greater Atlanta Affiliate
3525 Piedmont Rd NE
Atlanta,GA30305
58-1959763 501(c)(3) 90,000       Project Support
(100) The 100 Black Men of Atlanta Inc
241 Peachtree St NE
Atlanta,GA30303
58-1974429 501(c)(3) 30,000       Project Support
(101) The Clayton Cty Juvenille J Fund Inc
1408 Slake Plaza Dr
Morrow,GA30260
26-3202598 501(c)(3) 90,000       Project Support
(102) The Corporation of Mercer University
3001 Mercer Uni Dr
Atlanta,GA30341
58-0566167 501(c)(3) 80,000       Scholarships
(103) The Ctr for Black Women's Wellness Inc
477 Windsor St SW
Atlanta,GA30312
58-2212203 501(c)(3) 85,000       Project Support
(104) The Environmental Fund for Georgia Inc
101 Peachtree St NW
Atlanta,GA30303
58-2022001 501(c)(3) 86,000       Project Support
(105) The Health Initiative
1530 DeKalb Ave
Atlanta,GA30307
58-2271500 501(c)(3) 35,000       Project Support
(106) The Henry W Grady Health System Fdn Inc
192 Peachtree St
Atlanta,GA30303
58-2130437 501(c)(3) 60,500       Event Support\Annual Fundraiser
(107) The Link Counseling Center
348 Mt Vernon Hwy
Sandy Springs,GA30328
58-1109087 501(c)(3) 25,000       Project Support
(108) The Sheltering Arms
385 Centennial Olympic Pk
Atlanta,GA30313
58-0566236 501(c)(3) 85,000       Project Support
(109) Trees Atlanta Inc
225 Chester Ave
Atlanta,GA30316
58-1584758 501(c)(3) 50,000       Project Support
(110) United Negro College Fund Inc
229 Peachtree St
Atlanta,GA30303
13-1624241 501(c)(3) 5,750       Event Support\Awards Ceremony;Event Support\Annual
(111) United Way of Greater Atlanta Inc
40 Courtland St NE
Atlanta,GA30303
58-0566194 501(c)(3) 450,000       Project Support
(112) University of Georgia Fdn
311 East Campus Rd
Athens,GA30602
58-6033837 501(c)(3) 155,000       Scholarships
(113) University of West Georgia Fdn Inc
1601 Maple St
Carrollton,GA30118
58-6056464 501(c)(3) 80,000       Scholarships
(114) Veterans Empowerment Org Of Georgia Inc
373 West Lake Ave NW
Atlanta,GA30076
80-0219022 501(c)(3) 50,000       Project Support
(115) Voices for Georgia's Children
100 Edgewood Ave
Atlanta,GA30303
02-0678823 501(c)(3) 65,000       Project Support
(116) Wellspring Living Inc
860 Johnson Ferry Rd
Atlanta,GA30342
58-2614182 501(c)(3) 85,000       Project Support
(117) Year Up Inc
730 Peachtree St Ste 900
Atlanta,GA30308
04-3534407 501(c)(3) 50,000       Project Support
(118) YMCA of Greater Atlanta
957 N Highland Ave
Atlanta,GA30306
58-0593442 501(c)(3) 49,100       Event Support\Annual Fundraiser;Event Support\Awar
(119) YMCA of Metropolitan Atlanta Inc
101 Marietta St Ste 1100
Atlanta,GA30303
58-0566253 501(c)(3) 450,000       Project Support
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
119
3
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) 2018

Schedule I (Form 990) 2018
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 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) 2018



Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" 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
2018
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
No
1a
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.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
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.
4
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:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
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:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
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:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
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 ............
7
Yes
 
8
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 ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2018

Schedule J (Form 990) 2018
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
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1Gregory Adams
EVP, Group President
(i)

(ii)
0
-------------
1,224,496
0
-------------
3,466,327
0
-------------
4,391,419
0
-------------
1,114,562
0
-------------
29,740
0
-------------
10,226,544
0
-------------
4,383,200
2Dawn Bading
VP, Talent Acquisition
(i)

(ii)
0
-------------
283,731
0
-------------
191,373
0
-------------
36,795
0
-------------
84,330
0
-------------
37,697
0
-------------
633,926
0
-------------
0
3Kristin Bear
Assistant Secretary
(i)

(ii)
0
-------------
224,025
0
-------------
83,765
0
-------------
11,667
0
-------------
5,055
0
-------------
19,370
0
-------------
343,882
0
-------------
0
4Andrew Stephen Bradlyn
Exec Dir, Ctr for Clinical & O
(i)

(ii)
0
-------------
220,977
0
-------------
69,029
0
-------------
7,101
0
-------------
41,684
0
-------------
41,925
0
-------------
380,716
0
-------------
0
5Michael D Brown
VP, HR - Georgia
(i)

(ii)
0
-------------
248,523
0
-------------
64,636
0
-------------
39,750
0
-------------
59,184
0
-------------
37,132
0
-------------
449,225
0
-------------
0
6James Cullinan
VP, MSBD - GA
(i)

(ii)
0
-------------
295,845
0
-------------
252,648
0
-------------
76,956
0
-------------
86,952
0
-------------
23,191
0
-------------
735,592
0
-------------
45,588
7Craig Faerber
VP, CFO - Georgia
(i)

(ii)
0
-------------
376,843
0
-------------
329,502
0
-------------
19,730
0
-------------
102,800
0
-------------
30,583
0
-------------
859,458
0
-------------
0
8Deborah Friberg
SVP, Area Mgr - Central Valley
(i)

(ii)
0
-------------
247,081
0
-------------
76,753
0
-------------
55,238
0
-------------
63,541
0
-------------
29,646
0
-------------
472,259
0
-------------
3,309
9Pamela Hara
VP Quality/Risk Mgt & Pop Hlth
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
149,875
0
-------------
0
0
-------------
0
0
-------------
149,875
0
-------------
22,375
10Jonna Kirkwood
VP, COO - GA
(i)

(ii)
0
-------------
342,029
0
-------------
216,791
0
-------------
22,788
0
-------------
29,577
0
-------------
31,824
0
-------------
643,009
0
-------------
0
11Theresa Kurtinaitis
VP, Quality - GA
(i)

(ii)
0
-------------
233,036
0
-------------
35,387
0
-------------
38,182
0
-------------
88,495
0
-------------
28,828
0
-------------
423,928
0
-------------
0
12Kathryn Lancaster
EVP & CFO
(i)

(ii)
0
-------------
1,042,302
0
-------------
1,776,268
0
-------------
402,535
0
-------------
332,280
0
-------------
21,033
0
-------------
3,574,418
0
-------------
0
13Kirkland McGhee
Assistant Secretary
(i)

(ii)
0
-------------
261,328
0
-------------
85,926
0
-------------
7,220
0
-------------
43,038
0
-------------
30,598
0
-------------
428,110
0
-------------
0
14Thomas Meier
SVP, Corporate Treasurer
(i)

(ii)
0
-------------
462,542
0
-------------
633,581
0
-------------
115,824
0
-------------
8,208
0
-------------
33,258
0
-------------
1,253,413
0
-------------
0
15Julie Miller-Phipps
Regional President - SCAL
(i)

(ii)
0
-------------
886,797
0
-------------
882,077
0
-------------
255,643
0
-------------
-58,044
0
-------------
22,985
0
-------------
1,989,458
0
-------------
0
16Donald Orndoff
SVP, NFS
(i)

(ii)
0
-------------
435,028
0
-------------
536,354
0
-------------
176,170
0
-------------
169,668
0
-------------
32,416
0
-------------
1,349,636
0
-------------
117,119
17Jacqueline Sellers
Assistant Secretary
(i)

(ii)
0
-------------
199,568
0
-------------
72,157
0
-------------
28,607
0
-------------
20,496
0
-------------
14,766
0
-------------
335,594
0
-------------
0
18James Simpson
Regional President - GA
(i)

(ii)
0
-------------
473,839
0
-------------
540,497
0
-------------
174,830
0
-------------
194,400
0
-------------
36,906
0
-------------
1,420,472
0
-------------
0
19Arthur Southam
EVP, Health Plan Operations
(i)

(ii)
0
-------------
1,041,658
0
-------------
1,897,457
0
-------------
431,827
0
-------------
536,245
0
-------------
36,844
0
-------------
3,944,031
0
-------------
0
20Beverly Thomas
VP, Community & Public Affairs
(i)

(ii)
0
-------------
236,207
0
-------------
141,462
0
-------------
57,012
0
-------------
34,679
0
-------------
16,259
0
-------------
485,619
0
-------------
0
21Bernard Tyson
Chairman & CEO
(i)

(ii)
0
-------------
1,652,487
0
-------------
12,577,609
0
-------------
1,479,757
0
-------------
2,132,546
0
-------------
41,234
0
-------------
17,883,633
0
-------------
2,110,403
22Alfonse Upshaw
SVP,Corporate Controller & CAO
(i)

(ii)
0
-------------
438,858
0
-------------
356,406
0
-------------
18,380
0
-------------
99,558
0
-------------
28,853
0
-------------
942,055
0
-------------
0
23Michael Wathen
VP, HP Services & Admin - GA
(i)

(ii)
0
-------------
218,803
0
-------------
144,610
0
-------------
22,228
0
-------------
37,194
0
-------------
31,211
0
-------------
454,046
0
-------------
0
24Cherita White
Assistant Secretary
(i)

(ii)
0
-------------
127,330
0
-------------
7,798
0
-------------
2,081
0
-------------
6,588
0
-------------
33,938
0
-------------
177,735
0
-------------
0
25Hong-Sze Yu
VP, Brd & Corp Gov & Asst Secy
(i)

(ii)
0
-------------
249,307
0
-------------
94,714
0
-------------
17,313
0
-------------
60,176
0
-------------
25,870
0
-------------
447,380
0
-------------
0
26Mark Zemelman
SVP, General Counsel & Secy
(i)

(ii)
0
-------------
677,594
0
-------------
1,100,476
0
-------------
280,462
0
-------------
-12,297
0
-------------
34,354
0
-------------
2,080,589
0
-------------
0
Schedule J (Form 990) 2018

Schedule J (Form 990) 2018
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 - PAMELA HARA 127,500 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 $ 4,338,278 James Cullinan 57,180 Kathryn Lancaster 351,081 Thomas Meier 72,501 Julie Miller-Phipps 224,210 Donald Orndoff 149,555 Arthur M. Southam, MD 380,295 Beverly Thomas 30,141 Bernard Tyson 999,157 Mark Zemelman 232,150 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, PART II, COLUMN C THE ACTUARIAL VALUE FOR SOME INDIVIDUALS' DEFINED BENEFIT PLAN DECLINED IN 2018, RESULTING IN NEGATIVE VALUES IN COLUMN (C) IN SOME INSTANCES.
SCHEDULE J, PART II, COLUMN F AMOUNTS INCLUDED IN SCHEDULE J, PART II, COLUMN F INCLUDE AMOUNTS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION, AS WELL AS, DISTRIBUTIONS FROM A 457(B) PLAN THAT WERE PREVIOUSLY REPORTED AS REPORTABLE COMPENSATION IN ACCORDANCE WITH FORM 990 INSTRUCTIONS.
Schedule J (Form 990) 2018
Additional Data


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

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

Complete to provide information for responses to specific questions on
Form 990 or 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
2018
Open to Public
Inspection
Name of the organization
KAISER FOUNDATION HEALTH PLAN OF GEORGIAINC
 
Employer identification number

58-1592076
Return Reference Explanation
Form 990, Part III, Line 4A-4D 2018 Community Benefit Report Kaiser Foundation Health Plan of Georgia, Inc. I. Introduction A. About Kaiser Permanente Founded in 1942 to serve employees of Kaiser Industries and opened to the public in 1945, Kaiser Permanente is recognized as one of America's leading health care providers and nonprofit health plans. We were created to meet the challenge of providing American workers with medical care during the Great Depression and World War II, when most people could not afford to go to a doctor. Since our beginnings, we have been committed to helping shape the future of healthcare. Among the innovations Kaiser Permanente has brought to U.S. health care are: * Prepaid health plans, which spread the cost to make it more affordable * A focus on preventing illness and disease as much as on caring for the sick * An organized, coordinated system that puts as many services as possible under one roof-all connected by an electronic medical record Kaiser Permanente is an integrated health care delivery system comprised of Kaiser Foundation Hospitals (KFH), Kaiser Foundation Health Plan (KFHP), and physicians in the Permanente Medical Groups. Today we serve more than 12 million members in eight states and the District of Columbia. Our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. Care for members and patients is focused on their Total Health and guided by their personal physicians, specialists, and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery, and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education, and the support of community health. B. Kaiser Permanente's Approach to Community Health For more than 70 years, Kaiser Permanente has been dedicated to providing high-quality, affordable health care services and to improving the health of our members and the communities we serve. We believe good health is a fundamental right shared by all and we recognize that good health extends beyond the doctor's office and the hospital. It begins with healthy environments: fresh fruits and vegetables in neighborhood stores, successful schools, clean air, accessible parks, and safe playgrounds. Good health for the entire community requires equity and social and economic well-being. These are the vital signs of healthy communities. Better health outcomes begin where health starts, in our communities. Like our approach to medicine, our work in the community takes a prevention-focused, evidence-based approach. We go beyond traditional corporate philanthropy or grant making to pair financial resources with medical research, physician expertise, and clinical practices. Our community health strategy focuses on three areas: * Ensuring health access by providing individuals served at Kaiser Permanente or by our safety-net partners with integrated clinical and social services; * Improving conditions for health and equity by engaging members, communities, and Kaiser Permanente's workforce and assets; and * Advancing the future of community health by innovating with technology and social solutions. C. Kaiser Permanente's Total Contribution Kaiser Permanente provided $2.8 billion in community benefits in 2018. The amounts attributable to Kaiser Foundation Health Plan of Georgia are: * Financial Assistance at cost - $37.9 million * Medicaid - $10.3 million * Community health improvement services and community benefit operations - $3.1 million * Health Professions Education - $503,000 * Research - $1.6 million * Cash and in-kind contributions from community benefit - $12.9 million In addition to our direct spend on community benefits, we also leverage assets from across Kaiser Permanente to help us achieve our mission to improve the health of communities. This "Total Health" strategy includes our widely recognized activities around supplier diversity, socially responsible investing and environmental stewardship. II. Ensure Health Access A. Summary of The Strategy Ensuring access to high quality health care services for low-income populations within the communities we serve is core to our mission and tax-exempt status. Access to healthcare for vulnerable low-income populations is routinely identified in our Community Health Needs Assessments as one of the top health needs in the communities Kaiser Permanente serves. There are two main access challenges: coverage and care. Without access to adequate health insurance coverage, people may not receive the comprehensive and continuous medical care needed to help achieve maximum health outcomes. And without access to convenient and high-quality care by trusted providers, they are less likely to get and/or stay healthy. Over time, access challenges can compromise health outcomes as well as create additional burden on government to provide necessary social services. Kaiser Foundation Health Plan of Georgia supports the health access needs of our communities through a combination of coverage and care programs. We provide coverage to low-income populations through two key vehicles: first, via our participation in government programs like Medicaid and the Children's Health Insurance Programs (CHIP), and second, via our own Charitable Health Coverage (CHC) program, which provides a premium subsidy for Kaiser Permanente coverage for qualified low-income families and children who do not have access to public or private health coverage. Similarly, we provide care to low-income populations through two key vehicles: first, via our treatment of Medicaid and CHIP enrollees (not assigned to Kaiser Permanente), and second, via the Medical Financial Assistance (MFA) program, which is Kaiser Permanente's traditional charity care or financial assistance program (FAP). For Kaiser Foundation Health Plan, Inc. and all of its subsidiary health plans, the main way to address health access challenges is by absorbing the cost of the coverage programs described above. In 2018, Kaiser Foundation Health Plan of Georgia spent a total of $48.2 million on our coverage and care programs (at cost, net of all related revenues). In addition, it provided over $4.9 million in grants to help improve health access challenges, including but not limited to funding key safety-net partner organizations. B. Coverage Adequate health coverage means consistent access to comprehensive and continuous medical and preventative services for people to get and stay healthy, a much better and thorough alternative to episodic care at emergency departments. Coverage is good for the patient, good for Kaiser Permanente and good for the US overall because it helps people get and stay healthy and avoid costly hospital services. i. Coverage provided through Medicaid, CHIP and other government programs The Affordable Care Act has had a far-reaching impact on the landscape of government-sponsored programs, as these options have become a key source of health coverage for a significant portion of the US population. Kaiser Permanente has responded to this challenge by developing organizational strategies to enable low-income individuals to obtain and/or retain health coverage through Medicaid, CHIP or other government programs, even as their personal or financial circumstances may be changing. At the end of 2018, Kaiser Foundation Health Plan of Georgia was providing benefits to over 24,000 people through its Medicaid Managed Care contracts with other health plans. ii. Coverage provided through CHC CHC is a unique approach to caring for low-income uninsured persons in the community. The program provides a premium subsidy for a KFHP off exchange plan to low-income individuals and families who are not eligible for other public or privately sponsored coverage. Eligible participants receive a regular KFHP membership card and have access to the same services and providers as other KFHP individual and family plan members - a more effective alternative to a potentially costly emergency room visit or hospitalization. CHC members also receive cost sharing support that eliminates out of pocket costs for most covered services provided at Kaiser Permanente facilities. At the end of 2018, Kaiser Foundation Health Plan of Georgia was providing coverage to nearly 2,000 people through the CHC program.
C. Care To get and/or stay healthy, people need access to high quality care by providers they trust. This care must include preventative services and required medications so that people can avoid ending up in the emergency room or requiring more extensive services down the line. Kaiser Permanente helps low-income populations gain access to this type of care by leveraging the full scope of its integrated delivery system, including not only critical hospital-based services but also outpatient primary, specialty and pharmacy services. i. Care provided through Medicaid, CHIP and other government programs Kaiser Permanente provides a wide range of health care services to individuals enrolled in Medicaid, CHIP and other government programs, regardless of whether they are assigned to Kaiser Permanente or not. In addition to the individuals who received health coverage in 2018 due to Kaiser Permanente's participation in these government programs, Kaiser Foundation Health Plan of Georgia also subsidized care to people who are enrolled in these programs but not formally assigned to Kaiser Permanente. ii. Care subsidized by MFA The MFA program helps low-income, uninsured, and underserved patients receive access to care. MFA provides temporary financial assistance or free care to qualified patients who receive health care services from our providers, regardless of whether they have health coverage or are uninsured. MFA is open to all eligible patients (members and nonmembers) who meet financial criteria based on household size and income and have exhausted all private or public health care coverage options. The program also includes support for programs that are designed to enable access to Kaiser Permanente services through coordination with community-based organizations that address the health needs of low-income, primarily uninsured populations. Over the course of 2018, Kaiser Foundation Health Plan of Georgia subsidized care to over 53,000 people through the MFA program. D. Safety-Net Partnerships Kaiser Permanente is committed to building partnerships with the institutions that play a critical role in delivering health care for the uninsured and underserved, often referred to as the health care "safety-net." Through grants, training and technical assistance, we're working with safety-net hospitals and health centers to help these institutions reach those who are low-income, uninsured or under-resourced in our communities, and move the needle in eliminating health disparities. We do this by investing in quality improvement and other support efforts that aim to transform care and improve health access for those most in need. Specific examples of our efforts in 2018 include: * Kaiser Foundation Health Plan of Georgia's Mobile Health Vehicle (MHV) had a presence at school events, faith-based organizations, community gardening events, college campuses, libraries, apartment complexes, and mobile food pantries. MHV program screened 1,372 uninsured and underinsured people at 76 events, enabling the nurses on the MHV to provide access to preventive care and referral resources for high-need communities in 6 metro-Atlanta counties. III. Improve Conditions for Health and Equity A. Summary of the Strategy Healthy communities are critical to the health and wellness of every person - and this has always been central to our mission. That's why our strategy includes efforts to address the root causes of health, such as economic opportunity. Where community needs are greatest, we make direct investments to create conditions for health and equity, because healthy individuals need healthy communities, and healthy communities need healthy people to thrive. In 2018, Kaiser Foundation Health Plan of Georgia spent over $6.6 million on charitable contributions designed to improve conditions for health and equity. In addition to the charitable contributions awarded to improve conditions for health and equity, Kaiser Foundation Health Plan of Georgia also provided over $100,000 in charitable contributions for other Community Health activities and programs. B. Health and Wellness in Schools Our efforts to support health in schools are part of how we are advancing our vision for total health - a holistic approach that emphasizes the social, environmental, behavioral, and clinical aspects that shape one's well-being. Schools are passionate about ensuring that all students succeed. They need strong partners to help them address health as part of their strategy. That's why Kaiser Permanente created Thriving Schools, our all-in engagement to improve health for students, staff, and teachers. Our vision is that every community can count on their school as a champion for good health that enables great learning. Kaiser Permanente Thriving Schools is intentional about coordinating our own knowledge and existing work in school health with the good work of others. Through our valued partnerships with some of the country's most innovative organizations, we are able to provide concrete resources and pathways to health in schools. To create lasting change, we use our voice to advance local, regional, and national policies and a movement to make healthy schools the norm for everyone. A distinguishing feature of Thriving Schools is our complementary focus: we support students, staff, and teachers, and we address their physical, emotional, and social wellness. This approach builds a culture of wellness across the entire school. Specific examples of our efforts in 2018 include: * Kaiser Foundation Health Plan of Georgia launched the Resilience in School Environments (RISE) pilot in 2 schools to identify strategies and practices for increasing resiliency in school staff and students to inform future work to scale intervention. The purpose of RISE is to create and integrate a complementary, whole-school focus on increasing student and staff resilience through implementation of evidence-based practice, policy, and system improvements. In 2018, schools with the highest levels of staff burnout improved that measure by at least 20% and there was a significant increase in awareness and understanding of trauma informed practices and approaches across school sites. Plans were developed for scaling of RISE in 2019 to reach 200 schools onsite across Kaiser Permanente's Northern California, Southern California, Northwest, Colorado, Georgia, Mid-Atlantic States and Washington regions and thousands virtually to address trauma, mitigate negative effects of childhood adversity and toxic stress and build resilience in students and staff. * Kaiser Foundation Health Plan of Georgia activated multiple Kaiser Permanente assets in the high-need Fulton County Schools Achievement Zone. The 10 schools in the Achievement Zone are receiving the following Kaiser Permanente programs and resources: 1) Resiliency in School Environments (RISE) interventions to improve school policies and practices supporting resiliency in students and staff, 2) onsite mental health care for students, 3) Educational Theatre's SELFie (Social Emotional Learning For Individual Excellence), a semester long initiative for students to engage in self-discovery activities, including utilizing digital storytelling to capture and document their life experiences, and 4) TutorMates, a virtual literacy program in which adult mentors read with students one-on-one every week. C. Health and Wellness in Cities The places where we live, learn, work, and play - our cities and towns, our schools, our homes, our neighborhoods - have an enormous impact on our health. And how we shape those places, through public policy and the support for healthy environments, has the potential to make real, lasting impacts on our surroundings and our everyday quality of life. Through Kaiser Permanente's ongoing partnerships with community organizations, municipal leaders, and public health champions, we are working to incorporate health, equity and sustainability considerations into public policy and the built environment in ways that influence how neighborhoods take shape and grow. Specific examples of our efforts in 2018 include: * Kaiser Permanente joined the de Beaumont Foundation to support CityHealth. CityHealth advances nine policies that can make real, lasting impacts in people's health and quality of life in America's 40 largest cities. In 2018, CityHealth assessed 40 cities including Atlanta, Georgia on their policies and began to engage with city leaders to help them improve policies for Pre-K, inclusionary zoning, complete streets, smoke-free indoor air, and healthy food procurement. * Kaiser Permanente Georgia region awarded a $1 million grant to the Atlanta Community Food Bank, of which $250,000 was contributed in 2018, to support construction of a new 346,000 square foot facility that will allow the food bank to expand the meals they serve per year from 58 million to 130 million by 2028.
D. Economic Opportunity Inclusive economic growth is critical to both individual and community health. When there is a lack of economic opportunity in communities, the prospects for upward social mobility are diminished, often resulting in poorer health and higher mortality rates for people living in those communities. By contrast, economic growth and opportunity provides individuals with jobs, income, a sense of purpose, and opportunities to improve their economic circumstances overtime. As a large, influential institution in our communities, Kaiser Permanente recognizes that the way we do business can support economic opportunity in local communities through how we hire, purchase, build our facilities and partner with communities. Specific examples of our efforts in 2018 include: * Kaiser Permanente continued its commitment to source goods and services from the minority, women, veteran, and LGBTQ-owned business community as a member of the Billion Dollar Roundtable. As part of this commitment, we encouraged our own suppliers to also increase their sourcing of goods and services from the minority, women, veteran, and LGBTQ-owned business community. Furthermore, we also began to measure job creation that resulted from our procurement spending. In 2018, we found that our procurement spending led our supplier partners to create new jobs. * Kaiser Foundation Health Plan of Georgia partnered with Year Up, a nonprofit organization that provides young adults with the skills, experience, and support that will empower them to reach their potential through professional careers and higher education, to place 15 economically disadvantaged young people of color into Information Technology and customer service internships in Atlanta. E. Housing and Homelessness Housing stability is a key factor in a person's overall health and well-being. Without a safe, stable place to live, it is nearly impossible to maintain health or sustain health improvements achieved in a medical setting. With homelessness affecting more than 550,000 people every day throughout our country, the need for safe, stable and affordable housing has never been greater. Kaiser Permanente understands the connection between housing and health. Our impact investments aim to create more affordable housing, reduce the displacement of lower- and middle-income households, and end homelessness by ensuring access to supportive housing. Specific examples of our efforts in 2018 include: * Kaiser Permanente committed to address the housing and homelessness crisis in our communities. As part of that commitment, and working with Enterprise Community Partners, we developed the RxHome Fund, which will create and preserve multifamily rental homes for low-income residents throughout Kaiser Permanente's service areas. This strategy will protect current residents and preserve affordable units in the current housing stock. Also, with Enterprise Community Partners, we are supporting affordable housing development and preservation across all the communities in our service footprint. F. Environmental Stewardship We believe it is our obligation as a health care provider to minimize our environmental impact. We embed efforts to be environmentally responsible throughout our organization - in how we power our facilities, purchase food and medical supplies and equipment, manage waste, and invest in our communities. We also prioritize partnerships with others to develop policies and systems that strengthen community health and protect our environment. In 2016, Kaiser Permanente adopted an ambitious set of environmental goals to guide the organization for the decade ahead. These goals have raised the bar on environmental responsibility, not just for Kaiser Permanente but for all health care organizations. Kaiser Permanente pledges that by 2025 it will: * Become "carbon net positive" by buying enough clean energy and carbon offsets to remove more greenhouse gases from the atmosphere than it emits. * Buy all of its food locally or from farms and producers that use sustainable practices, including using antibiotics responsibly. * Recycle, reuse or compost 100 percent of its non-hazardous waste. * Reduce the amount of water it uses by 25 percent per square foot of buildings. * Increase its purchase of products and materials that meet environmental standards to 50 percent. * Meet international standards for environmental management at all its hospitals. * Pursue new collaborations to reduce environmental risks to the foodsheds, watersheds and air basins supplying its communities Specific examples of our efforts in 2018 include: * Kaiser Permanente finalized an agreement for a major renewable energy purchase, enabling us to achieve our goal of becoming carbon neutral in 2020. Kaiser Permanente dedicated 14% of overall spending on products to items that met our Environmentally Preferable Purchasing standards and dedicated 34% of spending on food to items produced locally or from farms and producers that use sustainable practices, including using antibiotics responsibly. * Kaiser Foundation Health Plan of Georgia responsibly reused, recycled or composted over 410 tons of materials and sent 51% of our waste to recycling. IV. Advance the Future of Community Health A. Summary of the Strategy Kaiser Permanente advances the future of community health by innovating with technology and social solutions. We need to increase our speed and capacity to respond to community needs and achieve equitable health outcomes. Innovation will increase our ability to identify, incubate and implement solutions to difficult community health problems. We work in partnership with our communities, using our collective knowledge to identify and implement creative solutions to difficult community health problems by: * Inspiring young people to pursue careers in health care * Conducting research to identify and eliminate disparities in care * Advancing health innovation and achieving greater and more equitable health outcomes In 2018, Kaiser Foundation Health Plan of Georgia spent a total of $3.3 million on programs to advance the future of community health (at cost, net of all related revenues). This included $503,000 in health professionals education, $1.6 million in research and $1.2 million in charitable contributions designed to spur innovation in the community health field. B. Health Professionals Education Our Graduate Medical Education (GME) program provides training and education for medical residents and interns in the interest of educating the next generation of physicians. The nationally acclaimed program attracts some of the top medical school graduates in the United States and serves as a national model by exposing future health care providers to an integrated health care delivery system. Residents are offered the opportunity to serve a large, culturally diverse patient base in a setting with sophisticated technology and information systems, established clinical guidelines and an emphasis on preventive and primary care. In 2018, Kaiser Foundation Health Plan of Georgia supported 7 interns and residents through the GME program. The majority of medical residents are studying within the primary care medicine areas of family practice, internal medicine, ob/gyn, pediatrics, preventive medicine, and psychiatry. In addition to GME, we provide a range of training and education programs for nurse practitioners, nurses, radiology and sonography technicians, physical therapists, post-graduate psychology and social work students, pharmacists, and other non-physician health professionals.
C. Research Kaiser Permanente has a long history of conducting health research related to both prevention and treatment of disease that benefits its members, the communities it serves and the nation. Kaiser Permanente's research efforts are core to the organization's mission to improve population health, and its commitment to continued learning. Research activities are conducted at Kaiser Permanente's eight regional research centers and three national groups: Kaiser Permanente Research Bank, Kaiser Permanente Center for Effectiveness & Safety Research; and Utility for Care Data Analysis. In addition, the Kaiser Foundation Research Institute administers and supports research at the research centers. Kaiser Permanente researchers study critical health issues including: cancer, cardiovascular conditions, diabetes, behavioral and mental health, and health care delivery improvement. Kaiser Permanente Research is broadly focused on 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 its geographically and demographically diverse members. In 2018, Kaiser Foundation Health Plan of Georgia engaged in 16 active studies including 6 clinical trials, and published 35 journal articles. The following is an example of a research project conducted in 2018: * Kaiser Foundation Health Plan of Georgia's Research Center, The Center for Research and Evaluation, published: Racial Disparities in Preemptive Referral for Kidney Transplantation in Georgia. Racial disparities persist in access to kidney transplantation. Racial differences in preemptive referral, or referral prior to dialysis start, may explain this discrepancy. Patient-level data on kidney transplant referrals (2005-2012) from all Georgia transplant centers were linked to the United States Renal Data System to examine racial disparities in preemptive referral, wait listing, and living donor transplant. Racial disparities in transplant receipt may be partially explained by disparities in preemptive referral. Interventions to reduce racial disparities in kidney transplant access may need to be targeted earlier in the disease process. D. Advancing Innovation Despite our nation's best efforts at addressing the myriad of challenges facing the health of our communities, we see that social, economic and health disparities among people continue to grow. At Kaiser Permanente, we're trying to shift that paradigm by working to advance conditions for health through the spread of best practices, innovation and technology. Kaiser Permanente works in partnership with our communities, using our collective knowledge to identify and implement creative solutions to difficult community health problems. Using technology as the backbone of our efforts, we are exploring new approaches for accelerating and scaling community health solutions to create greater impact. Together, we are advancing health innovation and achieving greater and more equitable health outcomes. Specific examples of our efforts in 2018 include: * Kaiser Permanente partnered with The Public Good Projects (PGP) to launch a strategy to reduce stigma and raise awareness around mental health conditions. PGP Mental Health campaign has three components which include Therapy Pets, Like One Another, and Mental Health Champions and each has its own audience.
FORM 990, PART VI, LINE 1a - Voting Member and Governing Body - THE EXECUTIVE COMMITTEE, CONSISTING OF THREE DIRECTORS, HAS AUTHORITY TO ACT FOR THE BOARD BETWEEN MEETINGS EXCEPT IT HAS NO AUTHORITY TO: 1. ADOPT, AMEND OR REPEAL BYLAWS. 2. AMEND OR REPEAL ANY RESOLUTION OF THE BOARD WHICH BY ITS EXPRESS TERMS IS NOT SO AMENDABLE OR REPEALABLE. 3. ELECT, APPOINT OR REMOVE DIRECTORS, DESIGNATE COMMITTEES OF THE BOARD OF DIRECTORS OR FILL VACANCIES IN THE BOARD OF DIRECTORS OR IN ANY SUCH COMMITTEE. 4. DISSOLVE, MERGE OR CONSOLIDATE THE CORPORATION. 5. ADOPT, AMEND OR REPEAL ARTICLES OF INCORPORATION. 6. SELL, LEASE, PLEDGE, TRANSFER OR EXCHANGE ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OF THE CORPORATION. 7. FIX COMPENSATION OF DIRECTORS FOR SERVING ON THE BOARD OR ON ANY COMMITTEE. 8. AUTHORIZE ANY DIRECT OR INDIRECT TRANSFER OF MONEY OR OTHER PROPERTY OR INCUR ANY INDEBTEDNESS TO OR FOR THE BENEFIT OF THE MEMBER OR THE DIRECTORS OR OFFICERS OF THE CORPORATION OR TO OR FOR THE BENEFIT OF TRANSFEREES IN LIQUIDATION (OTHER THAN CREDITORS OF THE CORPORATION). 9. TAKE ANY OTHER ACTION WHICH THE BOARD OF DIRECTORS IS NOT AUTHORIZED TO TAKE. FORM 990, PART VI, LINE 4 SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS The Bylaws of the Corporation were amended in 2018 as follows: On June 6, 2018, Section D-4(c) was amended so that the term of a Director ends on the earlier of December 31 of the year in which he or she has completed 12 years of service on the Board or he or she attains age 75, unless a Director is asked to remain on the Board for an interim transition period as currently provided for in the Bylaws.
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 RESOURCES 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, Communications 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 $20,411,010 CAPITAL TRANSFERS 50,000,000 GAIN/LOSS ON INVESTMENTS - TAX 688,095 GAIN/LOSS ON INVESTMENTS - BOOK (127,446) OTHER THAN TEMPORARY IMPAIRMENTS (3,752,319) ----------- TOTAL 67,219,340
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:56898782
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2018


Additional Data


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SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2018
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?
Yes No
(1)KAISER FOUNDATION HOSPITALS
ONE KAISER PLAZA 15L

OAKLAND,CA94612
94-1105628
HEALTH CARE CA 501(C)(3) 3 NA
 
 
No
(2)KAISER FOUNDATION HEALTH PLAN INC
ONE KAISER PLAZA 15L

OAKLAND,CA94612
94-1340523
HEALTH CARE CA 501(C)(3) 10 NA
 
 
No
(3)KAISER FOUNDATION HEALTH PLAN OF CO
ONE KAISER PLAZA 15L

OAKLAND,CA94612
84-0591617
HEALTH CARE CO 501(C)(3) 10 KFHP INC
 
Yes
 
(4)KAISER FOUNDATION HEALTH PLAN OF THE MAS
ONE KAISER PLAZA 15L

OAKLAND,CA94612
52-0954463
HEALTH CARE MD 501(C)(3) 10 KFHP INC
 
Yes
 
(5)KAISER FOUNDATION HEALTH PLAN OF THE NW
ONE KAISER PLAZA 15L

OAKLAND,CA94612
93-0798039
HEALTH CARE OR 501(C)(3) 10 KFHP INC
 
Yes
 
(6)KAISER FDN HEALTH PLAN OF WASHINGTON
ONE KAISER PLAZA 15L

OAKLAND,CA94612
91-0511770
HEALTH CARE WA 501(C)(3) 3 KFHPW HLDING
 
Yes
 
(7)KAISER HOSPITAL ASSET MANAGEMENT INC
ONE KAISER PLAZA 15L

OAKLAND,CA94612
94-3299125
ASSET MGMT CA 501(C)(3) 12-I KFH
 
Yes
 
(8)KAISER HEALTH PLAN ASSET MANAGEMENT INC
ONE KAISER PLAZA 15L

OAKLAND,CA94612
94-3299124
ASSET MGMT CA 501(C)(3) 12-I KFHP INC
 
Yes
 
(9)CAMP BOWIE SERVICE CENTER
ONE KAISER PLAZA 15L

OAKLAND,CA94612
94-3299123
ADMIN CA 501(C)(3) 12-I KFHP INC
 
Yes
 
(10)LOKAHI ASSURANCE LTD
ONE KAISER PLAZA 15L

OAKLAND,CA94612
91-2171891
WC PLACEMENT HI 501(C)(3) 12-I KFHP INC
 
Yes
 
(11)1800 HARRISON FOUNDATION
ONE KAISER PLAZA 15L

OAKLAND,CA94612
94-3317484
FINANCING CA 501(C)(3) 12-I KFHP INC
 
Yes
 
(12)KAISER HOSPITAL ASSISTANCE CORPORATION
ONE KAISER PLAZA 15L

OAKLAND,CA94612
31-1779500
FINANCING CA 501(C)(3) 12-I KFH
 
Yes
 
(13)KAISER HEALTH ALTERNATIVES
ONE KAISER PLAZA 15L

OAKLAND,CA94612
93-0954562
HEALTH CARE OR 501(c)(3) 10 KFHP INC
 
Yes
 
(14)KAISER PERMANENTE SCHOOL OF MEDICINEINC
ONE KAISER PLAZA 15L

OAKLAND,CA94612
81-4053028
MEDICAL EDU CA 501(C)(3) 2 KFH
 
Yes
 
(15)KFHPW HOLDINGS
ONE KAISER PLAZA 15L

OAKLAND,CA94612
93-0480268
HEALTH CARE WA 501(C)(3) 12-I KFHP INC
 
Yes
 
(16)GROUP HEALTH NORTHWEST
ONE KAISER PLAZA 15L

OAKLAND,CA94612
91-1216856
INACTIVE WA 501(C)(3) 12-I KFHP OF WA
 
Yes
 
(17)GROUP HEALTH OF WASHINGTON
ONE KAISER PLAZA 15L

OAKLAND,CA94612
91-1314907
INACTIVE WA 501(C)(3) 12-I KFHP OF WA
 
Yes
 
(18)KAISER FDN FOR THE ADV OF INTEGRATED HC
ONE KAISER PLAZA 15L

OAKLAND,CA94612
82-3819611
ADVOCACY CA 501(C)(4) N/A KFHP INC
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



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

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




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



(k)
Percentage
ownership


Yes No Yes No
(1) NXT CAP SR FD ILLC

191 N Wacker Dr 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
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) OAK TREE ASSURANCE LTD

ONE KAISER PLAZA 15L
OAKLAND,CA94612
03-0329760
INSURANCE VT NA
 
C CORP         No
(2) KAISER PERMANENTE INSURANCE COMPANY

ONE KAISER PLAZA 15L
OAKLAND,CA94612
94-3203402
INSURANCE CA NA
 
C CORP         No
(3) KAISER PROPERTIES SERVICES INC

ONE KAISER PLAZA 15L
OAKLAND,CA94612
94-3259432
REAL ESTATE CA NA
 
C CORP         No
(4) KAISER PERMANENTE INTERNATIONAL

ONE KAISER PLAZA 15L
OAKLAND,CA94612
94-3245176
CONSULTING CA NA
 
C CORP         No
(5) GROUP HEALTH SERVICES INC

ONE KAISER PLAZA 15L
OAKLAND,CA94612
91-1392222
INACTIVE WA NA
 
C CORP         No
(6) KFHP OF WASHINGTON OPTIONS INC

ONE KAISER PLAZA 15L
OAKLAND,CA94612
91-1467158
INSURANCE WA NA
 
C CORP         No


Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
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
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
Yes
 
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
Yes
 
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) Kaiser Foundation Health Plan Inc

l 13,063,824 per agreement
(2) Kaiser Foundation Health Plan Inc

m 37,928,106 per agreement
(3) Kaiser Foundation Health Plan Inc

p 134,074,615 per agreement
(4) Kaiser Foundation Health Plan Inc

q 767,728,816 per agreement
(5) Kaiser Foundation Health Plan Inc

r 1,730,050 per agreement
(6) Kaiser Foundation Health Plan Inc

s 444,209,680 per agreement
(7) Kaiser Foundation Hospitals

c 87,934 per agreement
(8) Kaiser Foundation Hospitals

e 248,000,000 per agreement
(9) Kaiser Foundation Hospitals

m 101,203,192 per agreement
(10) Kaiser Foundation Hospitals

p 2,740,373,196 per agreement
(11) Kaiser Foundation Hospitals

q 163,143,713 per agreement
(12) Kaiser Foundation Hospitals

s 50,000,000 per agreement
(13) Camp Bowie Service Center

m 125,092 per agreement
(14) Camp Bowie Service Center

p 21,663,540 per agreement
(15) Camp Bowie Service Center

s 2,789,026 per agreement
(16) Kaiser Permanente Insurance Company

l 13,284,341 per agreement
(17) Kaiser Permanente Insurance Company

m 17,165,021 per agreement
(18) Kaiser Permanente Insurance Company

p 286,181 per agreement
(19) Kaiser Permanente Insurance Company

q 2,162,191 per agreement
(20) Lokahi Assurance LTD

l 6,889,200 per agreement
(21) Lokahi Assurance LTD

m 4,200,000 per agreement
(22) Lokahi Assurance LTD

q 14,847,917 per agreement
(23) Lokahi Assurance LTD

r 2,728,000 per agreement
(24) Kaiser FDN Health Plan of the Northwest

l 369,333 per agreement
(25) Kaiser FDN Health Plan of the Northwest

m 309,044 per agreement
(26) Kaiser FDN Health Plan of the Northwest

q 63,695 per agreement
(27) Kaiser FDN Health Plan of Colorado

l 854,619 per agreement
(28) Kaiser FDN Health Plan of Colorado

m 811,299 per agreement
(29) Kaiser FDN Health Plan of Colorado

p 798,147 per agreement
(30) Kaiser FDN Health Plan of Colorado

r 144,605 per agreement
(31) KFHP of the Mid-Atlantic States Inc

l 2,118,057 per agreement
(32) KFHP of the Mid-Atlantic States Inc

m 1,935,704 per agreement
(33) KFHP of the Mid-Atlantic States Inc

p 26,756,192 per agreement
(34) KFHP of the Mid-Atlantic States Inc

q 476,515 per agreement
(35) Oaktree Assurance Ltd

l 1,829,148 per agreement
(36) Oaktree Assurance Ltd

m 1,973,809 per agreement
Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
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) 2018

Additional Data


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