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
2019
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 01-01-2016 , and ending 12-31-2016
BCheck if applicable:
CName of organization
KAISER FOUNDATION HEALTH PLAN
OF THE NORTHWEST
% SVP CC AND CAO
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

93-0798039
E Telephone number

G Gross receipts $ 4,467,836,301
F Name and address of principal officer:
JANET O'HOLLAREN
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: 1984
M State of legal domicile: OR
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 14
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 13
5 Total number of individuals employed in calendar year 2019 (Part V, line 2a) ...... 5 9,361
6 Total number of volunteers (estimate if necessary) ............. 6 134
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 5,665,581
b Net unrelated business taxable income from Form 990-T, line 39 ......... 7b  
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 13,725 19,040
9 Program service revenue (Part VIII, line 2g) ......... 3,526,336,068 3,730,426,021
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 17,958,222 26,581,351
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 364,133 378,147
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 3,544,672,148 3,757,404,559
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 165,780 140,236
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) 856,996,875 861,997,565
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).... 2,658,428,557 2,803,584,838
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 3,515,591,212 3,665,722,639
19 Revenue less expenses. Subtract line 18 from line 12....... 29,080,936 91,681,920
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,562,415,738 1,530,943,395
21 Total liabilities (Part X, line 26)............. 1,101,722,342 1,004,850,634
22 Net assets or fund balances. Subtract line 21 from line 20..... 460,693,396 526,092,761
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 (2019)
Form 990 (2019)
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 $ 3,246,064,649 including grants of $ 140,236 ) (Revenue $ 3,611,095,119 )
MEMBER HEALTH CARE SERVICES AND MEDICAL TRAINING FOR CARE IMPROVEMENT KAISER FOUNDATION HEALTH PLAN OF NORTHWEST (KFHP-NW) PROVIDES HOSPITAL, 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 NORTHWEST EDUCATES AND TRAINS MEDICAL STUDENTS AND OTHER HEALTH CARE PROFESSIONALS AND PROMOTES SCIENTIFIC AND NURSING EDUCATION IN ORDER TO IMPROVE CARE.
4b (Code:   ) (Expenses $ 21,578,943 including grants of $ 0 ) (Revenue $ 193,920 )
Charity Care (Medical Financial Assistance and Charitable Health Coverage) Kaiser Foundation Health Plan of the Northwest (KFHP-NW) provides charity care to low-income vulnerable patients through the Medical Financial Assistance (MFA) and Charitable Health Coverage (CHC) Programs. KFHP-NW offers financial assistance through the MFA program to help families and individuals with a demonstrated financial need pay for all or part of the cost of emergency or medically necessary care provided in Kaiser Permanente facilities and/or by Kaiser Permanente providers. In 2016, this program assisted more than 13,000 qualifying applicants. The CHC program offers regular Kaiser Foundation Health Plan membership at minimal cost to low income families who are not eligible for other public or privately sponsored coverage. More than 3,600 individuals were receiving comprehensive health care through this program at the end of 2016.
4c (Code:   ) (Expenses $ 166,219,198 including grants of $ 0 ) (Revenue $ 119,136,982 )
Medicaid and Other Government Sponsored Programs KFHP-NW is committed to improving medical care for beneficiaries of Medicaid and other government sponsored programs, not only for KFHP-NW members, but also within the communities we serve. At the end of 2016, more than 28,000 individuals were receiving the benefits of full membership in KFHP-NWs Medicaid managed care program. Approximately 12,000 more individuals were members of the Childrens Health Insurance Program (CHIP). In addition, KFHP-NW provided health care on a fee-for-service basis for Medicaid beneficiaries who were not enrolled as KFHP-NW members.
(Code:   ) (Expenses $ 2,030,530 including grants of $ 0 ) (Revenue $ 0 )
SEE SCHEDULE O COMMUNITY BENEFIT REPORT
4d Other program services (Describe in Schedule O.)
(Expenses $ 2,030,530 including grants of $ 0 ) (Revenue $ 0 )
4e Total program service expensesMediumBullet3,435,893,320
Form 990 (2019)
Form 990 (2019)
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)? ...
2
 
No
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 V......
10
 
 
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
 
No
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 XIIClick 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
 
Form 990 (2019)
Form 990 (2019)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
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
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 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) 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, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, 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
986
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 (2019)
Form 990 (2019)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
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
9,361
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
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
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
 
 
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
 
 
Form 990 (2019)
Form 990 (2019)
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
14
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
13
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
OR
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:
MediumBulletSVP CC AND CAOONE KAISER PLAZA SUITE 15L   OAKLAND,CA94612 (510) 271-6611
Form 990 (2019)
Form 990 (2019)
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.

See instructions for the order in which to list the persons above.
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) Ramon F Baez......................................................................
Director
 0.25
.................
4.75 		X           0 152,591 0
(2) Regina M Benjamin MD MBA......................................................................
Director
 0.5
.................
8.0 		X           0 197,178 0
(3) Jeffrey E Epstein......................................................................
Director
 0.5
.................
7.5 		X           0 206,871 0
(4) Leslie S Heisz......................................................................
Director
 0.25
.................
4.75 		X           0 215,118 0
(5) David Hoffmeister......................................................................
Director
 0.0
.................
8.0 		X           0 225,809 0
(6) Judith A Johansen JD......................................................................
Director
 0.5
.................
8.0 		X           0 240,707 0
(7) Kim J Kaiser......................................................................
Director
 1.0
.................
6.5 		X           0 216,547 0
(8) Philip A Marineau......................................................................
Director
 0.58
.................
5.86 		X           0 229,371 0
(9) Edward Pei......................................................................
Director
 0.25
.................
7.25 		X           0 226,739 18,000
(10) Margaret E Porfido JD......................................................................
Director
 0.5
.................
6.0 		X           0 247,358 0
(11) Richard Shannon MD......................................................................
Director
 0.5
.................
5.0 		X           0 212,000 0
(12) Cynthia A Telles PHD......................................................................
Director
 0.5
.................
7.0 		X           0 223,809 0
(13) Bernard Tyson......................................................................
Chairman & CEO
 6.0
.................
44.0 		X   X       0 8,529,498 720,185
(14) Eugene Washington MD......................................................................
Director
 0.25
.................
6.75 		X           0 186,626 0
(15) Gregory Adams......................................................................
EVP, Group President
 6.0
.................
44.0 		    X       0 2,457,650 688,025
(16) Maryann Bodayle......................................................................
Assistant Secretary
 1.0
.................
49.0 		    X       0 166,251 33,529
(17) Kathryn Lancaster......................................................................
EVP & CFO
 4.0
.................
46.0 		    X       0 2,681,226 588,601
Form 990 (2019)
Form 990 (2019)
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) Donna Lynne........................................................................
EVP, GP & Region Pres - CO
 4.0
.......................46.0 		    X       0 5,214,011 131,383
(19) Andrew Mcculloch........................................................................
Regional President - Northwest
 25.0
.......................25.0 		    X       0 1,045,365 545,870
(20) Thomas Meier........................................................................
SVP, Corporate Treasurer
 2.0
.......................48.0 		    X       0 1,050,818 138,764
(21) Donald Orndoff........................................................................
SVP, NFS
 5.0
.......................45.0 		    X       0 935,840 216,315
(22) Jacqueline Sellers........................................................................
Assistant Secretary
 6.0
.......................44.0 		    X       0 265,122 88,088
(23) Arthur Southam........................................................................
EVP, Health Plan Operations
 5.0
.......................45.0 		    X       0 2,775,635 464,416
(24) Deborah Stokes........................................................................
SVP,Corporate Controller & CAO
 4.0
.......................46.0 		    X       0 503,944 3,920
(25) Alfonse Upshaw........................................................................
SVP,Corporate Controller & CAO
 4.0
.......................46.0 		    X       0 616,612 108,314
(26) William Wiechmann........................................................................
ASSISTANT SECRETARY
 50.0
.......................0.0 		    X       0 417,986 161,661
(27) Hong-Sze Yu........................................................................
Assistant Secretary
 5.0
.......................45.0 		    X       0 304,345 126,932
(28) Mark Zemelman........................................................................
SVP, General Counsel & Secy
 1.0
.......................49.0 		    X       0 1,630,173 369,974
(29) Keith Forrester........................................................................
VP, MSBD - Northwest
 50.0
.......................0.0 		      X     0 375,680 124,919
(30) David Lake........................................................................
VP, Strategy & Health Plan Ops
 50.0
.......................0.0 		      X     0 375,021 98,746
(31) Susan Mullaney........................................................................
VP, COO - NW
 50.0
.......................0.0 		      X     0 697,523 147,394
(32) Janet O'Hollaren........................................................................
VP, COO - NW
 50.0
.......................0.0 		      X     0 361,442 284,296
(33) Karen Schartman........................................................................
VP & CFO
 50.0
.......................0.0 		      X     0 641,893 197,132
(34) Stephen Shawn Barton........................................................................
Exec Dir, Revenue Cycle - NW
 50.0
.......................0.0 		        X   0 345,358 78,789
(35) Mary L Durham........................................................................
VP, The Center Health Research
 50.0
.......................0.0 		        X   0 432,058 231,452
(36) Francisco Hurtarte........................................................................
VP, HR - Northwest
 50.0
.......................0.0 		        X   0 367,841 158,285
(37) Wendy N Watson........................................................................
VP, Ambul. Care & Clin. Svcs
 50.0
.......................0.0 		        X   0 355,587 149,756
(38) Kenneth R Wright........................................................................
VP, Dental Care Svcs - NW
 50.0
.......................0.0 		        X   0 373,044 127,322
(39) Thomas W Chapman EDD........................................................................
Director
 0.0
.......................0.0 		          X 0 513,713 0
(40) J Eugene Grisby III PHD........................................................................
Director
 0.0
.......................0.0 		          X 0 27,039 0
(41) George Halvorson........................................................................
Chairman
 0.0
.......................0.0 		          X 0 37,258 4,120
(42) J Neal Purcell........................................................................
Director
 0.0
.......................0.0 		          X 0 46,000 0
(43) Daniel Garcia........................................................................
SVP, Chief Compliance Officer
 2.0
.......................48.0 		          X 0 1,137,595 2,170
(44) Victoria Zatkin........................................................................
VP, Off of Brd & Corp Gov Svc
 5.0
.......................45.0 		          X 0 216,783 1,728
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 0 37,679,035 6,010,086
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 MediumBullet1,450
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
KAISER FOUNDATION HOSPITALS,
500 NE MULTNOMAH STREET
PORTLAND,OR97232 		MEDICAL SERVICES 903,072,809
NORTHWEST PERMANENTE PC,
500 NE MULTNOMAH ST 15TH FLOOR
PORTLAND,OR97232 		MEDICAL SERVICES 587,455,003
OREGON HEALTH SCIENCE UNIVERSITY,
PO BOX 3181 SW SAM JACKSON PARK RD
PORTLAND,OR97201 		MEDICAL SERVICES 66,905,360
PERMANENTE DENTAL ASSOCIATES,
500 NE MULTNOMAH ST 16TH FLOOR
PORTLAND,OR97232 		DENTAL SERVICES 50,396,097
LEGACY SALMON CREEK HOSPITAL,
PO BOX 2077
PORTLAND,OR97208 		MEDICAL SERVICES 52,443,715
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet65
Form 990 (2019)
Form 990 (2019)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f 19,040
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 19,040
Program Service RevenueAmt Business Code
2a MBR HLTH CARE PREM 900099 2,494,430,775 2,494,430,775    
b MEDICARE 900099 849,640,661 849,640,661    
c SUPPL CHARGE/PHARM 900099 155,401,688 149,736,107 5,665,581  
d NON-PLAN & IND REV 900099 10,502,273 10,502,273    
e OTHER PRGRM SERV 900099 220,450,624 220,450,624    
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 3,730,426,021
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 21,230,515      
4 Income from investment of tax-exempt bond proceedsMediumBullet 0      
5 Royalties...........MediumBullet 0      
(ii) Personal (i) Real
6a Gross rents   378,147 6a
b Less: rental expenses     6b
c Rental income or (loss) 0 378,147 6c
d Net rental income or (loss).......MediumBullet 378,147     378,147
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 7,558,900 708,223,678 7a
b Less: cost or other basis and sales expenses 3,942,804 706,488,938 7b
c Gain or (loss) 3,616,096 1,734,740 7c
d Net gain or (loss).........MediumBullet 5,350,836     5,350,836
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a 0
b Less: direct expenses ... 8b 0
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a 0
b Less: direct expenses ... 9b 0
c Net income or (loss) from gaming activities..MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances ..
10a 0
b Less: cost of goods sold .. 10b 0
c Net income or (loss) from sales of inventory..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 3,757,404,559 3,724,760,440 5,665,581 5,728,983
Form 990 (2019)
Form 990 (2019)
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 .... 140,236 140,236
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 0  
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. ............. 0  
4 Benefits paid to or for members ....... 0  
5 Compensation of current officers, directors, trustees, and key employees ........... 0      
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........ 568,754,058 538,777,049 29,977,009  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 84,362,881 84,362,881    
9 Other employee benefits ....... 162,132,790 148,355,556 13,777,234  
10 Payroll taxes ........... 46,747,836 46,782,302 -34,466  
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 3,620,685   3,620,685  
c Accounting ........... 1,440,556   1,440,556  
d Lobbying ........... 0      
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 964,427   964,427  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 368,533,705 342,250,033 26,283,672  
12 Advertising and promotion .... 6,303,364 1,301,927 5,001,437  
13 Office expenses ....... 11,474,949 10,356,716 1,118,233  
14 Information technology ...... 192,940,579 154,725,210 38,215,369  
15 Royalties .. 0      
16 Occupancy ........... 15,832,720 15,832,720    
17 Travel ............ 2,941,892 2,629,508 312,384  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 0      
19 Conferences, conventions, and meetings .... 1,579,299   1,579,299 0
20 Interest ........... 1,462,631 1,462,631    
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization .. 37,482,375 37,482,375    
23 Insurance ... 19,218,987 19,218,887 100  
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 MEDICAL SERVICE PAYMENTS 1,526,158,576 1,526,158,576    
b SUPPLIES 467,965,255 429,525,229 38,440,026  
c INTER-REGIONAL CHARGES 66,193,722 44,480,180 21,713,542  
d STATE & LOCAL TAXES 5,917,507 5,568,380 349,127  
e All other expenses 73,553,609 26,482,924 47,070,685  
25 Total functional expenses. Add lines 1 through 24e 3,665,722,639 3,435,893,320 229,829,319 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 (2019)
Form 990 (2019)
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 ........ 3,919,950 1 6,999,134
2 Savings and temporary cash investments ......... 0 2 0
3 Pledges and grants receivable, net ...... 0 3 0
4 Accounts receivable, net ............. 105,843,518 4 85,739,329
5 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
0 6 0
7 Notes and loans receivable, net ........... 0 7 0
8 Inventories for sale or use ............ 35,761,814 8 34,821,233
9 Prepaid expenses and deferred charges ...... 5,500,144 9 9,726,861
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 754,026,306
b Less: accumulated depreciation 10b 449,468,088 287,844,049 10c 304,558,218
11 Investments—publicly traded securities . 1,063,694,804 11 1,024,569,534
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 ........... 59,851,459 15 64,529,086
16 Total assets. Add lines 1 through 15 (must equal line 33)... 1,562,415,738 16 1,530,943,395
Liabilities 17 Accounts payable and accrued expenses ..... 307,208,177 17 361,918,917
18 Grants payable ... 0 18 0
19 Deferred revenue ......... 35,783,439 19 40,179,105
20 Tax-exempt bond liabilities ......... 0 20 0
21 Escrow or custodial account liability. Complete Part IV of Schedule D 0 21 0
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .. 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 758,730,726 25 602,752,612
26 Total liabilities. Add lines 17 through 25.. 1,101,722,342 26 1,004,850,634
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions ..........   27  
28 Net assets with donor restrictions ...........   28  
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds ..... 179,712,721 29 179,712,721
30 Paid-in or capital surplus, or land, building or equipment fund ... 0 30 0
31 Retained earnings, endowment, accumulated income, or other funds 280,980,675 31 346,380,040
32 Total net assets or fund balances ........... 460,693,396 32 526,092,761
33 Total liabilities and net assets/fund balances ........ 1,562,415,738 33 1,530,943,395
Form 990 (2019)
Form 990 (2019)
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
3,757,404,559
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
3,665,722,639
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
91,681,920
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
460,693,396
5
Net unrealized gains (losses) on investments ...............
5
2,106,739
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
-28,389,294
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
526,092,761
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 (2019)
Form 990 (2019)
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 instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
KAISER FOUNDATION HEALTH PLAN
OF THE NORTHWEST
Employer identification number

93-0798039
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . 55,792 90,559 105,012 13,725 19,040 284,128
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose 2,980,226,987 3,143,279,380 3,315,037,313 3,520,930,084 3,724,760,440 16,684,234,204
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....           0
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...           0
5 The value of services or facilities furnished by a governmental unit to the organization without charge           0
6 Total. Add lines 1 through 5 2,980,282,779 3,143,369,939 3,315,142,325 3,520,943,809 3,724,779,480 16,684,518,332
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.) 16,684,518,332
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
9 Amounts from line 6... 2,980,282,779 3,143,369,939 3,315,142,325 3,520,943,809 3,724,779,480 16,684,518,332
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. 16,369,318 14,364,423 14,526,894 18,139,668 21,608,662 85,008,965
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. 0 0 0 0 0 0
c Add lines 10a and 10b. 16,369,318 14,364,423 14,526,894 18,139,668 21,608,662 85,008,965
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.           0
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..           0
13 Total support. (Add lines 9, 10c, 11, and 12.).. 2,996,652,097 3,157,734,362 3,329,669,219 3,539,083,477 3,746,388,142 16,769,527,297
14
Section C. Computation of Public Support Percentage
15
15
99.493 %
16
16
99.479 %
Section D. Computation of Investment Income Percentage
17
17
0.507 %
18
18
0.521 %
19a
b
20
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
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) 2019

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

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

Schedule A (Form 990 or 990-EZ) 2019
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity		  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions		  
9 Distributable amount for 2019 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions 		(ii)
Underdistributions
Pre-2019 		(iii)
Distributable
Amount for 2019
1 Distributable amount for 2019 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI).
See instructions.		  
3 Excess distributions carryover, if any, to 2019:
a From 2014.......  
b From 2015.......  
c From 2016.......  
d From 2017.......  
e From 2018.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2019 distributable amount  
i Carryover from 2014 not applied (see
instructions) 		 
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2019 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2019 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2019, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions.		  
6 Remaining underdistributions for 2019. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions.		  
7 Excess distributions carryover to 2020. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a Excess from 2015.....  
b Excess from 2016.....  
c Excess from 2017.....  
d Excess from 2018.....  
e Excess from 2019.....  
Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2019


Additional Data


Software ID:  
Software Version:  
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
2019
Open to Public
Inspection
If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
KAISER FOUNDATION HEALTH PLAN
OF THE NORTHWEST
Employer identification number

93-0798039
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) 2019

Schedule C (Form 990 or 990-EZ) 2019
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd 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) 2016 (b) 2017 (c) 2018 (d) 2019 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))		  
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2019


Schedule C (Form 990 or 990-EZ) 2019
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes|No
(b)
Amount
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? ..........................................................
Yes
 
23,000
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
Yes
 
64,300
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
52,437
j
Total. Add lines 1c through 1i ....................................................................................................
139,737
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
Part IV
Supplemental Information
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, Lines 1a through 1i LOBBYING ACTIVITY BY NONELECTING PUBLIC CHARITIES THE ORGANIZATION ("Health Plan") IS A MEMBER OF THE KAISER PERMANENTE MEDICAL CARE PROGRAM AND PARTICIPATED IN AND BENEFITED FROM LOBBYING ACTIVITIES CONDUCTED AT THE REGIONAL AND NATIONAL LEVELS FOR THE BENEFIT OF ITS ENROLLED MEMBERS, THE BROADER COMMUNITY AND FOR THE HEALTH CARE INDUSTRY AS A WHOLE. AS AN ORGANIZATION EXEMPT FROM INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(C)(3), Health Plan HAS A POLICY PROHIBITING ANY OF Health Plan'S RESOURCES BEING USED IN ANY POLITICAL CAMPAIGNS. THIS POLICY IS CLOSELY MONITORED FOR COMPLIANCE. DURING THE YEAR THIS ORGANIZATION MADE COMMENTS OR STATEMENTS CONCERNING LEGISLATION AND BALLOT INITIATIVES WHICH MAY AFFECT THE HEALTH CARE INDUSTRY. Health Plan ENGAGED IN CONVERSATIONS WITH AND/OR WRITTEN COMMUNICATIONS TO VARIOUS FEDERAL, STATE, AND LOCAL OFFICIALS REGARDING MATTERS WHICH AFFECTED THE HEALTHCARE INDUSTRY AS A WHOLE. THE AMOUNT OF MONEY INVOLVED IN THE ACTIVITIES IS DETAILED ON LINES A THROUGH I. Health Plan EMPLOYS INDIVIDUALS, INCLUDING ONE OR MORE REGISTERED LOBBYISTS AND/OR MAY RETAIN ONE OR MORE PROFESSIONAL CONSULTANTS TO REPRESENT Health Plan'S INTERESTS IN VARIOUS LEGISLATIVE AND REGULATORY BODIES AND FROM TIME-TO-TIME TO KEEP INFORMED ABOUT FEDERAL AND STATE LEGISLATION HAVING AN IMPACT ON Health Plan'S CHARITABLE ACTIVITIES AS AN EXEMPT HEALTH MAINTENANCE ORGANIZATION. THESE INDIVIDUALS ATTEMPT TO ENSURE THAT PROPOSED LEGISLATION AND ENACTED LAWS ARE COMPATIBLE WITH THE INTERESTS OF Health Plan, ITS MEMBERS AND ITS PATIENTS BY PERFORMING THE FOLLOWING ACTIVITIES: - COLLECTING, ANALYZING AND DISTRIBUTING WITHIN THE ORGANIZATION, PUBLIC AND PRIVATE POLICY RECOMMENDATIONS REGARDING PROPOSED LEGISLATION THAT AFFECT THE OPERATION OF Health Plan AND ITS ABILITY TO PROVIDE QUALITY HEALTH AND MEDICAL CARE SERVICES TO ITS MEMBERS AND THE BROADER COMMUNITY IN A COST EFFECTIVE MANNER. - PROVIDING APPROPRIATE INFORMATIONAL MATERIALS TO LEGISLATORS AND THEIR STAFFS THAT PERTAIN TO MATTERS OF COMMON INTEREST IN THE HEALTH CARE COMMUNITY AND IN THE NOT-FOR-PROFIT COMMUNITY. - PREPARING WRITTEN AND ORAL TESTIMONY, APPEARING AT LEGISLATIVE HEARINGS, MONITORING LEGISLATIVE PROCEEDINGS AND MEETING WITH LEGISLATORS AND/OR THEIR STAFFS REGARDING ISSUES PERTINENT TO THE MISSION OF Health Plan. INDIVIDUALS APPEARING AT SUCH HEARINGS AND MEETINGS FOR AND ON BEHALF OF Health Plan OFTEN ARE REPRESENTING THE INTERESTS OF COMMON INTEREST GROUPS AS WELL AS THE INTERESTS OF THE MEMBERS AND PATIENTS OF Health Plan. OTHER EMPLOYEES AND OFFICERS PERFORM SERVICES BY DELIVERING SPEECHES AT VARIOUS PUBLIC AND PRIVATE FUNCTIONS AND IN SERVING AS FACULTY IN HEALTHCARE RELATED EDUCATIONAL PROGRAMS THROUGHOUT THE COMMUNITY.
Schedule C (Form 990 or 990EZ) 2019


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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 instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
KAISER FOUNDATION HEALTH PLAN
OF THE NORTHWEST
Employer identification number

93-0798039
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 FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
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 FASB 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) 2019

Schedule D (Form 990) 2019
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
Term 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 .....   31,047,254 31,047,254
b Buildings ....   481,577,359 298,099,054 183,478,305
c Leasehold improvements   38,772,023 23,248,511 15,523,512
d Equipment ....   165,370,620 117,077,835 48,292,785
e Other .....   37,259,049 11,042,687 26,216,362
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 304,558,218
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
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
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
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
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 602,752,612
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
Schedule D, Part X, Line 2 ASC 740 Footnote: THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE UNDER ASC 740.
Schedule D (Form 990) 2019


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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
2019
Open to Public
Inspection
Name of the organization
KAISER FOUNDATION HEALTH PLAN
OF THE NORTHWEST
Employer identification number
93-0798039
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) American Heart Association of OR & SW WA
4380 SW Macadam Ave
Portland,OR97239 		13-5613797 501(c)(3) 49,540       Annual Event
(2) March of Dimes Foundation - Oregon Chapter
PO Box 5037
Portland,OR97205 		13-1846366 501(c)(3) 5,500       March for Babies 2016
(3) Salem Keizer Education Foundation
PO Box 993
Salem,OR97308 		93-0831467 501(c)(3) 5,500       Awesome Awards and Back to School Lunch
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
3
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2019

Schedule I (Form 990) 2019
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
Schedule I, Part I, Question 2 At the end of their funding cycle grantees are required to submit a final REPORT WHICH DELINEATES ACCOMPLISHMENTS RELATED TO STATED OBJECTIVES. LARGE GRANTS (TYPICALLY OVER $100,000) MAY REQUIRE QUARTERLY PROGRESS REPORTS.
Schedule I (Form 990) 2019



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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
KAISER FOUNDATION HEALTH PLAN
OF THE NORTHWEST
Employer identification number

93-0798039
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 on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........
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 on 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
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 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) 2019

Schedule J (Form 990) 2019
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1Gregory Adams
EVP, Group President 		(i)

(ii)		  
-------------
895,570 		 
-------------
1,220,621 		 
-------------
341,459 		0
-------------
661,797 		0
-------------
26,228 		0
-------------
3,145,675 		0
-------------
0
2Ramon F Baez
Director 		(i)

(ii)		  
-------------
141,676 		 
-------------
0 		 
-------------
10,915 		0
-------------
0 		0
-------------
0 		0
-------------
152,591 		0
-------------
0
3Stephen Shawn Barton
Exec Dir, Revenue Cycle - NW 		(i)

(ii)		  
-------------
227,752 		 
-------------
112,902 		 
-------------
4,704 		0
-------------
52,604 		0
-------------
26,185 		0
-------------
424,147 		0
-------------
0
4Regina M Benjamin MD MBA
Director 		(i)

(ii)		  
-------------
189,500 		 
-------------
0 		 
-------------
7,678 		0
-------------
0 		0
-------------
0 		0
-------------
197,178 		0
-------------
0
5Maryann Bodayle
Assistant Secretary 		(i)

(ii)		  
-------------
149,101 		 
-------------
14,912 		 
-------------
2,238 		0
-------------
24,809 		0
-------------
8,720 		0
-------------
199,780 		0
-------------
0
6Thomas W Chapman EDD
Director 		(i)

(ii)		  
-------------
0 		 
-------------
0 		 
-------------
513,713 		0
-------------
0 		0
-------------
0 		0
-------------
513,713 		0
-------------
448,199
7Mary L Durham
VP, The Center Health Research 		(i)

(ii)		  
-------------
210,043 		 
-------------
132,612 		 
-------------
89,403 		0
-------------
208,726 		0
-------------
22,726 		0
-------------
663,510 		0
-------------
25,339
8Jeffrey E Epstein
Director 		(i)

(ii)		  
-------------
199,500 		 
-------------
0 		 
-------------
7,371 		0
-------------
0 		0
-------------
0 		0
-------------
206,871 		0
-------------
0
9Keith Forrester
VP, MSBD - Northwest 		(i)

(ii)		  
-------------
225,830 		 
-------------
113,545 		 
-------------
36,305 		0
-------------
104,462 		0
-------------
20,457 		0
-------------
500,599 		0
-------------
0
10Daniel Garcia
SVP, Chief Compliance Officer 		(i)

(ii)		  
-------------
274,311 		 
-------------
828,960 		 
-------------
34,324 		0
-------------
-13,502 		0
-------------
15,672 		0
-------------
1,139,765 		0
-------------
0
11J Eugene Grisby III PHD
Director 		(i)

(ii)		  
-------------
0 		 
-------------
0 		 
-------------
27,039 		0
-------------
0 		0
-------------
0 		0
-------------
27,039 		0
-------------
27,039
12George Halvorson
Chairman 		(i)

(ii)		  
-------------
0 		 
-------------
0 		 
-------------
37,258 		0
-------------
4,120 		0
-------------
0 		0
-------------
41,378 		0
-------------
17,548
13Leslie S Heisz
Director 		(i)

(ii)		  
-------------
199,500 		 
-------------
0 		 
-------------
15,618 		0
-------------
0 		0
-------------
0 		0
-------------
215,118 		0
-------------
0
14David Hoffmeister
Director 		(i)

(ii)		  
-------------
214,500 		 
-------------
0 		 
-------------
11,309 		0
-------------
0 		0
-------------
0 		0
-------------
225,809 		0
-------------
0
15Francisco Hurtarte
VP, HR - Northwest 		(i)

(ii)		  
-------------
272,508 		 
-------------
80,000 		 
-------------
15,333 		0
-------------
131,641 		0
-------------
26,644 		0
-------------
526,126 		0
-------------
0
16Judith A Johansen JD
Director 		(i)

(ii)		  
-------------
227,000 		 
-------------
0 		 
-------------
13,707 		0
-------------
0 		0
-------------
0 		0
-------------
240,707 		0
-------------
0
17Kim J Kaiser
Director 		(i)

(ii)		  
-------------
204,500 		 
-------------
0 		 
-------------
12,047 		0
-------------
0 		0
-------------
0 		0
-------------
216,547 		0
-------------
0
18David Lake
VP, Strategy & Health Plan Ops 		(i)

(ii)		  
-------------
200,292 		 
-------------
143,220 		 
-------------
31,509 		0
-------------
70,764 		0
-------------
27,982 		0
-------------
473,767 		0
-------------
0
19Kathryn Lancaster
EVP & CFO 		(i)

(ii)		  
-------------
823,192 		 
-------------
1,486,990 		 
-------------
371,044 		0
-------------
570,456 		0
-------------
18,145 		0
-------------
3,269,827 		0
-------------
15,594
20Donna Lynne
EVP, GP & Region Pres - CO 		(i)

(ii)		  
-------------
250,147 		 
-------------
1,703,753 		 
-------------
3,260,111 		0
-------------
120,565 		0
-------------
10,818 		0
-------------
5,345,394 		0
-------------
2,322,965
21Philip A Marineau
Director 		(i)

(ii)		  
-------------
222,000 		 
-------------
0 		 
-------------
7,371 		0
-------------
0 		0
-------------
0 		0
-------------
229,371 		0
-------------
0
22Andrew Mcculloch
Regional President - Northwest 		(i)

(ii)		  
-------------
441,398 		 
-------------
543,690 		 
-------------
60,277 		0
-------------
518,712 		0
-------------
27,158 		0
-------------
1,591,235 		0
-------------
0
23Thomas Meier
SVP, Corporate Treasurer 		(i)

(ii)		  
-------------
382,345 		 
-------------
523,823 		 
-------------
144,650 		0
-------------
111,392 		0
-------------
27,372 		0
-------------
1,189,582 		0
-------------
42,160
24Susan Mullaney
VP, COO - NW 		(i)

(ii)		  
-------------
371,883 		 
-------------
169,681 		 
-------------
155,959 		0
-------------
117,385 		0
-------------
30,009 		0
-------------
844,917 		0
-------------
0
25Janet O'Hollaren
VP, COO - NW 		(i)

(ii)		  
-------------
260,453 		 
-------------
82,834 		 
-------------
18,155 		0
-------------
256,666 		0
-------------
27,630 		0
-------------
645,738 		0
-------------
0
26Donald Orndoff
SVP, NFS 		(i)

(ii)		  
-------------
418,115 		 
-------------
491,764 		 
-------------
25,961 		0
-------------
185,822 		0
-------------
30,493 		0
-------------
1,152,155 		0
-------------
0
27Edward Pei
Director 		(i)

(ii)		  
-------------
214,000 		 
-------------
0 		 
-------------
12,739 		0
-------------
18,000 		0
-------------
0 		0
-------------
244,739 		0
-------------
0
28Margaret E Porfido JD
Director 		(i)

(ii)		  
-------------
229,500 		 
-------------
0 		 
-------------
17,858 		0
-------------
0 		0
-------------
0 		0
-------------
247,358 		0
-------------
0
29J Neal Purcell
Director 		(i)

(ii)		  
-------------
11,000 		 
-------------
0 		 
-------------
35,000 		0
-------------
0 		0
-------------
0 		0
-------------
46,000 		0
-------------
18,192
30Karen Schartman
VP & CFO 		(i)

(ii)		  
-------------
326,201 		 
-------------
236,996 		 
-------------
78,696 		0
-------------
183,689 		0
-------------
13,443 		0
-------------
839,025 		0
-------------
0
31Jacqueline Sellers
Assistant Secretary 		(i)

(ii)		  
-------------
195,357 		 
-------------
60,644 		 
-------------
9,121 		0
-------------
75,309 		0
-------------
12,779 		0
-------------
353,210 		0
-------------
0
32Richard Shannon MD
Director 		(i)

(ii)		  
-------------
212,000 		 
-------------
0 		 
-------------
0 		0
-------------
0 		0
-------------
0 		0
-------------
212,000 		0
-------------
0
33Arthur Southam
EVP, Health Plan Operations 		(i)

(ii)		  
-------------
851,992 		 
-------------
1,521,837 		 
-------------
401,806 		0
-------------
438,204 		0
-------------
26,212 		0
-------------
3,240,051 		0
-------------
7,159
34Deborah Stokes
SVP,Corporate Controller & CAO 		(i)

(ii)		  
-------------
42,705 		 
-------------
395,366 		 
-------------
65,873 		0
-------------
2,147 		0
-------------
1,773 		0
-------------
507,864 		0
-------------
0
35Cynthia A Telles PHD
Director 		(i)

(ii)		  
-------------
212,500 		 
-------------
0 		 
-------------
11,309 		0
-------------
0 		0
-------------
0 		0
-------------
223,809 		0
-------------
0
36Bernard Tyson
Chairman & CEO 		(i)

(ii)		 0
-------------
1,274,847 		0
-------------
6,056,494 		0
-------------
1,198,157 		0
-------------
686,080 		0
-------------
34,105 		0
-------------
9,249,683 		0
-------------
0
37Alfonse Upshaw
SVP,Corporate Controller & CAO 		(i)

(ii)		  
-------------
330,597 		 
-------------
250,737 		 
-------------
35,278 		0
-------------
83,390 		0
-------------
24,924 		0
-------------
724,926 		0
-------------
0
38Eugene Washington MD
Director 		(i)

(ii)		  
-------------
186,176 		 
-------------
0 		 
-------------
450 		0
-------------
0 		0
-------------
0 		0
-------------
186,626 		0
-------------
0
39Wendy N Watson
VP, Ambul. Care & Clin. Svcs 		(i)

(ii)		  
-------------
243,438 		 
-------------
96,074 		 
-------------
16,075 		0
-------------
123,742 		0
-------------
26,014 		0
-------------
505,343 		0
-------------
0
40William Wiechmann
ASSISTANT SECRETARY 		(i)

(ii)		  
-------------
253,663 		 
-------------
147,536 		 
-------------
16,787 		0
-------------
135,153 		0
-------------
26,508 		0
-------------
579,647 		0
-------------
0
41Kenneth R Wright
VP, Dental Care Svcs - NW 		(i)

(ii)		  
-------------
221,132 		 
-------------
107,148 		 
-------------
44,764 		0
-------------
94,557 		0
-------------
32,765 		0
-------------
500,366 		0
-------------
0
42Hong-Sze Yu
Assistant Secretary 		(i)

(ii)		  
-------------
219,652 		 
-------------
68,784 		 
-------------
15,909 		0
-------------
104,663 		0
-------------
22,269 		0
-------------
431,277 		0
-------------
0
43Victoria Zatkin
VP, Off of Brd & Corp Gov Svc 		(i)

(ii)		  
-------------
25,068 		 
-------------
99,763 		 
-------------
91,952 		0
-------------
1,394 		0
-------------
334 		0
-------------
218,511 		0
-------------
85,158
44Mark Zemelman
SVP, General Counsel & Secy 		(i)

(ii)		  
-------------
547,086 		 
-------------
839,524 		 
-------------
243,563 		0
-------------
339,949 		0
-------------
30,025 		0
-------------
2,000,147 		0
-------------
0
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
Schedule J, Part I, line 3 METHODS USED TO ESTABLISH COMPENSATION OF CEO/EXECUTIVE DIRECTOR: THE FILING ORGANIZATION RELIED ON A RELATED ORGANIZATION THAT USED ONE OR MORE OF THE METHODS DESCRIBED BELOW TO ESTABLISH THE TOP MANAGEMENT OFFICIALS' COMPENSATION: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE OF A RELATED ORGANIZATION.
Schedule J, Part I, Line 4b SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENT: Gregory Adams 292,234 Mary L. Durham 56,299 Kathryn Lancaster 322,425 Donna Lynne 3,229,867 Thomas Meier 105,522 Arthur Southam 352,920 Deborah Stokes 59,716 Bernard Tyson 815,201 Victoria Zatkin 85,158 Mark Zemelman 197,189 SOME OF THE PARTICIPANTS LISTED IN SCHEDULE J, PART II PARTICIPATED IN NONQUALIFIED SUPPLEMENTAL RETIREMENT PLANS. UNDER THESE PLANS, THE ORGANIZATION MAKES ANNUAL CONTRIBUTIONS TO A NOTIONAL ACCOUNT ON BEHALF OF EACH PARTICIPANT. CONTRIBUTIONS VARY BY POSITION, LEVEL AND PAY, AND VEST OVER TIME BASED ON AGE AND/OR SERVICE. PARTICIPANT ACCOUNTS ARE CREDITED WITH A FIXED RATE OF INTEREST, INVESTED IN AVAILABLE MUTUAL FUNDS OR A COMBINATION OF BOTH. CERTAIN OFFICERS ACCRUE A BENEFIT THAT VESTS BASED ON AGE AND SERVICE AND TARGETS A PERCENTAGE OF FINAL AVERAGE PAY LESS PRIOR PLAN OFFSETS. UNVESTED AMOUNTS ARE SUBJECT TO RISK OF FORFEITURE.
Schedule J, Part I, line 7 NON-FIXED PAYMENTS: THE ORGANIZATION PROVIDED NON-FIXED PAYMENTS TO SOME OF THE PERSONS LISTED. PAYMENTS WERE MADE UNDER INCENTIVE PLANS, BASED ON ATTAINMENT OF ORGANIZATIONAL PERFORMANCE GOALS AND INDIVIDUAL PERFORMANCE, DESIGNED TO SUPPORT THE ORGANIZATION'S MISSION TO PROVIDE HIGH-QUALITY, AFFORDABLE CARE AND IMPROVE THE HEALTH OF ITS MEMBERS AND THE COMMUNITIES IT SERVES.
SCHEDULE J, PART II, COLUMN C THE ACTUARIAL VALUE FOR SOME INDIVIDUALS' DEFINED BENEFIT PLAN DECLINED IN 2016, RESULTING IN NEGATIVE VALUES IN COLUMN (C) IN SOME INSTANCES.
Schedule J (Form 990) 2019

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
2019
Open to Public
Inspection
Name of the organization
KAISER FOUNDATION HEALTH PLAN
OF THE NORTHWEST
Employer identification number

93-0798039
Return Reference Explanation
Form 990, Heading, Item B, Amended Return Revision of deferred compensation in Part VII and Schedule J for one officer/director. Form 990, PART VI, LINE 4 The Bylaws of the Corporation were amended in 2016 as follows: On March 3, 2016: - The Independent Director definition was removed and noted as being defined in the Corporate Governance Guidelines. - Article D, Directors, Section D-2 was amended to change the number and description of inside Directors. - Article D, Directors, Section D-4 was amended to modify the term and retirement age for Directors. - Article F, Committees, Section F-4, Executive Committee, was amended to change the Committee composition and remove tax exemption and executive selection, performance appraisal, and succession duties.
Form 990, PART VI, QUESTION 6 Kaiser foundation health plan, inc. is the sole member. Upon dissolution, remaining assets shall be distributed to a 501(c)(3) organization.
Form 990, PART VI, QUESTION 7A KFHP, INC. appoints the directors (and fills vacancies and has authority to remove directors). The same individuals who comprise the board of directors of KFHP also serve as THE directors of KFHP COLORADO, NORTHWEST, MID-ATLANTIC STATES, AND KFHP WASHINGTON.
Form 990, PART VI, QUESTION 7B THE FOLLOWING ACTIONS OF THE CORPORATION REQUIRE APPROVAL OF THE SOLE MEMBER: A) REMOVAL OF THE CHAIRMAN OF THE BOARD OR THE PRESIDENT, THE GROUP PRESIDENT OR REGIONAL PRESIDENT; B) AMENDMENT OF ARTICLE D, SECTION D-4 OF THE BYLAWS - ELECTION AND TERM OF OFFICE.
Form, PART VI, QUESTION 11B Form 990 Review Process: 1. Key information necessary for the preparation of the tax return is obtained and/or confirmed with internal sources including regional finance, executive compensation, community benefits, treasury, government relations, and legal. 2. 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, QUESTIONS 12C COMPLIANCE ENFORCEMENT A. REGULARLY AND CONSISTENTLY MONITORS COMPLIANCE WITH THE CONFLICTS OF INTEREST POLICY - KAISER PERMANENTE REGULARLY MONITORS COMPLIANCE WITH THE CONFLICTS OF INTEREST POLICY IN 3 KEY WAYS: A1. THE KAISER PERMANENTE COMPLIANCE HOTLINE IS AVAILABLE TO ALL EMPLOYEES AND VENDORS TO REPORT ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. ALL CALLS ARE ANSWERED BY A THIRD PARTY AND PROVIDED TO KAISER PERMANENTE'S NATIONAL COMPLIANCE OFFICE FOR REVIEW AND APPROPRIATE ACTION. EMPLOYEES CAN REPORT ANONYMOUSLY. RETALIATION IS PROHIBITED. REPORTS OF ACTUAL OR POTENTIAL CONFLICTS OF INTEREST ARE GENERATED AND INVESTIGATIONS ARE CONDUCTED AS REQUIRED AND INFORMATION IS TRACKED AND TRENDED TO DETERMINE IF ADDITIONAL GUIDANCE IS REQUIRED TO AVOID OR MANAGE CONFLICTS OF INTEREST. COMPLIANCE HOTLINE REPORTS ARE PROVIDED FOR REVIEW AND ACTION TO THE KAISER FOUNDATION HEALTH PLAN/HOSPITALS BOARDS OF DIRECTORS ANNUALLY. A2. THE NATIONAL COMPLIANCE OFFICE AND INTERNAL AUDIT SERVICES ANNUALLY REVIEW THE DIRECTORS', OFFICERS', KEY EMPLOYEES', AND EXECUTIVES' ANNUAL CONFLICTS OF INTEREST QUESTIONNAIRE DISCLOSURES AND PROVIDE DIRECTION ON ANY INVESTIGATIONS REQUIRED. INVESTIGATIONS ARE DOCUMENTED, TRACKED AND TRENDED TO DETERMINE IF ADDITIONAL CONTROLS OR EDUCATION IS REQUIRED. IN ADDITION, CONFLICTS OF INTEREST QUESTIONNAIRE REPORTS ARE PROVIDED FOR REVIEW AND ACTION TO THE KAISER FOUNDATION HEALTH PLAN/HOSPITALS BOARDS OF DIRECTORS ANNUALLY; AND A3. ANNUALLY, AS A COMPONENT OF THE EXTERNAL AUDIT, AN OUTSIDE CERTIFIED PUBLIC ACCOUNTING FIRM REVIEWS THE ANNUAL CONFLICTS OF INTEREST QUESTIONNAIRES PROCESS COMPLETED BY DIRECTORS, OFFICERS, KEY EMPLOYEES, AND EXECUTIVES, AND ACTIONS TAKEN AS A RESULT OF THE DISCLOSURES. THE RESULTS OF THE ANNUAL AUDIT, INCLUDING ANY FINDINGS IN THIS AREA ARE PRESENTED TO THE KAISER FOUNDATION HEALTH PLAN/HOSPITALS AUDIT AND COMPLIANCE COMMITTEE. B. REGULARLY AND CONSISTENTLY ENFORCES COMPLIANCE WITH THE CONFLICTS OF INTEREST POLICY - TO ENSURE CONSISTENCY IN THE ENFORCEMENT OF THE POLICY KAISER PERMANENTE USES THE FOLLOWING STEPS AS A GENERAL GUIDELINE: B1. REPRESENTED EMPLOYEES ARE SUBJECT TO ANY CORRECTIVE/DISCIPLINARY ACTION PROVISIONS DESCRIBED IN SPECIFIC REGIONAL/NATIONAL COLLECTIVE BARGAINING AGREEMENTS AND/OR ORGANIZATIONAL POLICIES AND PRACTICES. B2. KAISER PERMANENTE NOTIFIES EMPLOYEES OF THE NATIONAL HUMAN RESOURCES POLICY NO. 14. CORRECTIVE/DISCIPLINARY ACTION POLICY DURING NEW EMPLOYEE ORIENTATION AND IN ANNUAL COMPLIANCE TRAINING. B3. IN THE EVENT THAT IT IS NECESSARY TO DISCIPLINE ANY EMPLOYEE BECAUSE OF, BUT NOT LIMITED TO, FAILURE TO COMPLY WITH APPLICABLE LEGAL/REGULATORY REQUIREMENTS, KAISER PERMANENTE POLICIES AND PROCEDURES, OR THE PRINCIPLES OF RESPONSIBILITY, OR FOR UNSATISFACTORY PERFORMANCE OR MISCONDUCT, COACHING/COUNSELING AND/OR CORRECTIVE/DISCIPLINARY ACTION MAY INCLUDE, BUT IS NOT LIMITED TO: - ORAL DISCUSSION AND/OR WARNING BY THE EMPLOYEE'S IMMEDIATE SUPERVISOR OR HIGHER LEVEL MANAGER TO CORRECT THE PROBLEM; - WRITTEN NOTICE, WITH OR WITHOUT FINAL WARNING; - PAID OR UNPAID SUSPENSION, WITH OR WITHOUT FINAL WARNING; - TERMINATION OF EMPLOYMENT.
Form 990, PART VI, QUESTION 15A/B COMPENSATION DETERMINATION THE EXECUTIVE COMPENSATION PROGRAM AS ADMINISTERED BY KAISER FOUNDATION HEALTH PLAN, INC. IS DESIGNED TO RECRUIT, RETAIN AND MOTIVATE QUALIFIED SENIOR MANAGEMENT PERSONNEL. SENIOR MANAGEMENT PERSONNEL HAVE A SIGNIFICANT IMPACT ON THE STRATEGIC AND POLICY DIRECTION AND RESULTS OF THE ORGANIZATION. THEREFORE, THE EXECUTIVE COMPENSATION PROGRAM IS, TO A SIGNIFICANT DEGREE, PERFORMANCE-BASED. THE COMPENSATION PROGRAM IS REVIEWED ANNUALLY BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS AND THE MANAGEMENT COMMITTEE ON COMPENSATION. PRIOR TO PAYMENT, ALL PROGRAMS AND PAYMENTS TO THE CEO, EXECUTIVE DIRECTOR, AND TOP MANAGEMENT OFFICIALS (EXECUTIVES) ARE REVIEWED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS AND THE MANAGEMENT COMMITTEE ON COMPENSATION. BASE PAY FOR EXECUTIVE POSITIONS IS ESTABLISHED AT A LEVEL COMPARABLE TO THE RELEVANT MARKET. IN ADDITION, OTHER COMPONENTS OF THE COMPENSATION PROGRAM BEAR 'AT-RISK' FEATURES DESIGNED TO FOCUS ON STRATEGICALLY IMPORTANT PERFORMANCE GOALS AND TO ASSIST IN ATTRACTING AND RETAINING TOP PERFORMERS. THE EXECUTIVE COMPENSATION PROGRAM IS TARGETED TO BE COMPETITIVE TO THE COMPARABLE EXTERNAL MARKET IN WHICH THE ORGANIZATION COMPETES FOR EXECUTIVE LEADERSHIP. EVALUATION OF COMPARABLE PAY DATA IS PERFORMED BY AN INDEPENDENT COMPENSATION, BENEFIT & HUMAN RESOURCE CONSULTING FIRM. THE COMPENSATION PROGRAM FOCUSES ON OBJECTIVES IN THE AREAS OF QUALITY OF MEMBER CARE AND SERVICE, MEMBERSHIP GROWTH, FINANCIAL SOUNDNESS, AND THE COMMUNITY AND SOCIAL MISSION OF THE ORGANIZATION.
Form 990, PART VI, QUESTION 18 Forms 990 are available on www.guidestar.org.
Form 990, PART VI, QUESTION 19 Public Inspection Copy: Governing documents, conflict of interest policy are available upon request as disclosed to other regulatory bodies. Financial Statements are on file with state insurance agency on a statutory basis (stand alone entity). Combined data is published for Kaiser Foundation Health Plan Inc. and subsidiaries and Kaiser Foundation Hospitals and Subsidiaries with Independent Auditors' Report. To request copies contact: Vice President, Government Relations Kaiser Foundation Health Plan and Hospitals One Kaiser Plaza, 18th Floor Oakland, CA 94612
Form 990, PART VII, SECTION A, COLUMN B: Hours for Related Organization: Individuals who are both officers and members of Boards of Directors work full time as employees as well as fulfill their board assignment. All officers work full time in their employee capacity. Full time work may require in excess of the traditional 40 hour week. Given the integrated nature of our organization, employees may provide support for various Kaiser Permanente companies. The average hours per week reported for the filing organization and related organizations was estimated.
Form 990, PART XI, LINE 9 CHANGE IN pension and other retirement liabilities $(25,348,077) BOOK-TO-TAX DIFFERENCE ON SALE OF INVESTMENTS 1,712,596 OTHER THAN TEMPORARY IMPAIRMENT LOSS (4,753,813) ---------------- TOTAL (28,389,294)
FORM 990, PART III, LINES 4A - 4D 2016 Community Benefit Report Kaiser Foundation Health Plan of the Northwests Commitment to the Community Kaiser Foundation Health Plan of the Northwest (Northwest Health Plan or KFHP-NW) provides and arranges comprehensive health care services for members on a predominantly prepaid basis. Its contractual obligations to group and individual members are fulfilled by contracting with Kaiser Foundation Hospitals (KFH) and Permanente Medical Group physicians to provide health care services for its members. KFHP-NW strives for excellence in serving its members through market-leading performance in quality and service. As a subsidiary of Kaiser Foundation Health Plan, Inc. (KFHP, Inc.), membership is available without regard to age, sex, race, religion, or national origin, or to the individuals ability to pay. Northwest Health Plan members are broadly representative of the communities served. Once enrolled, a member may maintain membership regardless of health or employment status. As related nonprofit organizations, Kaiser Foundation Health Plan, Inc. and Kaiser Foundation Health Plan of the Northwest are committed to improving the health of communities beyond enrolled membership. Annual investments in a range of Community Benefit programs are a fundamental embodiment of the organizations ongoing commitment to improve the general wellbeing within the broader community. These investments result in intentional, planned, measurable, and accountable benefits intended to address many of the health challenges faced at the individual, local, state, and national levels. In 2007, Kaiser Foundation Health Plan, Inc.s board of directors refined the focus of the organizations Community Benefit programs and established the following four priority areas which have come to be known as "Streams of Work": A. Care and Coverage for Low-Income People Creates and supports programs that lower the financial barriers for the under- and uninsured. B. Community Health Initiatives (CHI) Seeks to measurably improve the health of the communities we serve. Designs, delivers, and sustains long-term programs that engage communities in work to improve conditions in their neighborhoods. C. Safety Net Partnerships Builds partnerships with community clinics, local health departments, and public hospitals. Provides funding, technical assistance, dissemination of care management, and quality improvements technology to help improve care and expand treatment capacity for vulnerable populations. D. Developing and Disseminating Knowledge Improves health care by sharing our knowledge educating practitioners, advancing research, empowering consumers, and informing policymakers about evidence-based care and health. In addition to the streams of work above, KFHP-NW also made contributions to benefit the communities served in the following areas: E. Other Community Benefit Investments Support Community Benefit activities and programs beyond the national streams of work, including the administrative expenses of regional Community Benefit departments dedicated to supporting the organizations Community Benefit programs and services and coordinating related initiatives. F. Environmental Stewardship Protecting and improving the natural environment is a key component of KFHP-NWs mission to improve the health of the community it serves. Although costs associated with this initiative are not included in the dollars reported as Community Benefit investments, efforts in this area contribute to advancing a broader vision emphasizing healthy people and healthy environments while also improving health care quality and affordability. The following are details of the Community Benefit activities provided by Kaiser Foundation Health Plan of the Northwest: In 2016, Northwest Health Plan served nearly 553,000 members and expended approximately $70.5 million (at cost, net of $121.3 million of related revenues) to support Community Benefit activities. The following summarizes many of the signature Community Benefit programs and services grouped according to the national Streams of Work. A. Care and Coverage for Low-Income People Improving health care access for those with limited incomes and resources is fundamental to Kaiser Foundation Health Plan of the Northwests mission. In 2016, Northwest Health Plan spent approximately $68.5 million (at cost, net of $121.3 million of related revenues) to address the financing and delivery of health care for populations vulnerable due to socio-economic status, illness, ethnicity, age or other factors. Program beneficiaries (under- and uninsured) received free or discounted care in a Kaiser Permanente facility or from a Permanente provider. A.1. Charitable Care (Medical Financial Assistance and Charitable Health Coverage Programs) In Oregon and Washington, Northwest Health Plan provides charity care to low-income vulnerable populations through the Medical Financial Assistance (MFA) and Charitable Health Coverage (CHC) programs. In 2016, Northwest Health Plan spent approximately $21.4 million (at cost, net of $194 thousand of related revenues) on under- and uninsured patients.
A.1.1. Medical Financial Assistance (MFA) Program Northwest Health Plans Medical Financial Assistance program provides financial assistance for emergency and medically necessary services, medications, and supplies to patients with a demonstrated financial need. Patients must receive health care services at a Kaiser Permanente facility and/or from a Kaiser Permanente provider. Eligibility is based upon prescribed levels of income to patients who have exhausted other private and public sources of support. In 2016, KFHP-NW provided approximately $12.8 million (at cost, net of related revenues of $0) of services under this program. At KFHP-NW, uninsured patients receive a discount on hospital and professional charges for emergency or other medically necessary care without an application and regardless of income level. The discount is provided to ensure that an uninsured individual is not charged more for emergency or other medically necessary services than the amounts generally billed to insured individuals receiving equivalent care. Contracted collection agency practices are aligned with the organizations social values and IRC section 501(r). Additionally, any patient experiencing financial hardship due to high medical expenses relative to their income level may qualify for the program under the high medical expense criteria. Northwest Health Plans MFA eligibility criteria allows all insured patients falling at or below 300% of the Federal Poverty Guidelines (FPG) to receive full (100%) write off of medical charges. Any patient who does not meet income-based eligibility criteria, but is experiencing financial hardship due to high medical expenses relative to their income may qualify for MFA under high medical expense criteria. Eligibility for high medical expenses exists when the patients incurred out-of-pocket medical and pharmacy expenses over the previous 12-month period is equal to or exceeds 10% of annual income. High medical expenses can apply to any income level. In Oregon and Washington, the MFA program also covers full or partial expenses for dental services if applicants meet qualifying guidelines. Promoting this medical-dental integration within the community is a priority for Kaiser Foundation Health Plan of the Northwest. The Health Plan supports the Oregon Primary Care Association in its efforts to bring dental directors together from Federally Qualified Health Centers to share best practices. Health Plan also employs a Community Benefit dentist for several hours each week to work with safety net partners to increase dental access and medical-dental integration in our community. In 2016, the MFA program assisted more than 13,000 qualified applicants, including nearly 2,000 patients who were not otherwise covered by a health care plan offered by Kaiser Foundation Health Plan of the Northwest. This population received full or partial forgiveness for nearly 116,000 outpatient visits and over 17,000 prescriptions. Approximately 400 people received dental financial assistance in 2016. A.1.1.1. Community Medical Financial Assistance (CMFA) The MFA program also includes support for community based initiatives, known as Community Medical Financial Assistance (CMFA) programs. CMFA programs are designed to broaden access to health care within the community and help KFHP-NW fulfill its objectives to reduce the financial barriers that limit access to care for qualified low income populations. Northwest Health Plan is partnering with Project Access NOW (PAN) in Multnomah, Clackamas and Washington Counties, the Medical Foundation of Marion and Polk Counties in Oregon, and The Free Clinics of Clark County and Cowlitz County in Washington in a broad based community initiative that builds access to health care for low income and uninsured people through the provision of donated medical services. Patients referred to Kaiser Permanente facilities from the partnering organizations are set up with a Health Record Number, Primary Care Provider and Home Clinic for a period of one year. These patients then have access to the full range of Kaiser Permanente services. Services may include primary care, specialty care and hospitalizations. This prevents medical emergencies, alleviates the burden on clinics and emergency rooms when medical conditions persist untreated, and enables patients to be treated for the root causes of their symptoms. A.1.2. Charitable Health Coverage (CHC) Program Charitable Health Coverage is a unique approach to caring for low-income uninsured persons in the community. Eligible participants receive a regular Kaiser Permanente Health Plan membership card and access to the full range of services and providers a much better alternative to potentially costly emergency room visits or hospitalization. This allows Northwest Health Plan to invest in the longer term health of patients and the community. KFHP-NWs CHC programs have a long history of making a real difference in the lives of low-income people who might otherwise have no permanent medical home. During 2016, KFHP-NW invested approximately $8.6 million (at cost, net of $194 thousand of related revenues) to support the CHC program. The CHC program includes a separately administered premium subsidy that CHC members use for the purchase of a standard off-exchange Kaiser Permanente Individual/Family (KPIF) gold level plan. Applicants must not be eligible or enrolled in any private or public health plan. Eligible siblings age 3 to 19 can also receive services. To ensure that patient cost share obligations do not become a barrier to care, a Medical Financial Assistance award is provided to CHC members at the time of enrollment in the CHC program. Recertification takes place about every two years to confirm that members remain eligible to participate. A.1.2.1. Child Health Plan Plus The Child Health Plan Plus targets eligible students. This program is open to children of low-income families who reside in one of six school districts and who do not have access to other health insurance options. The program provides comprehensive medical, dental and prescription coverage to children between kindergarten and 12th grade, and these children must come from a household with income is at or below 350% of the Federal Poverty Guidelines. At the end of 2016, more than 3,600 children were covered by membership in this program. In 2014, Health Plan started offering dental as part of the Child Health Plan Plus. Child Health Plan has been in place as a medical-only plan for many years, but added the essential dental benefit for new enrollees. In addition, all members in the existing plan (without a dental benefit) converted to the new plan (with a dental benefit) on October 1, 2014. All basic dental treatment is covered, but implants or orthodontia treatment are not. These members can receive care at any Kaiser Foundation Health Plan of the Northwest dental office. A.2. Participation in Medicaid and Other Government-Sponsored Programs Kaiser Foundation Health Plan of the Northwest has a long history of providing access to low- and moderate-income individuals as a nonprofit organization. KFHP-NW participates in Medicaid and other government-sponsored programs under a variety of models, depending on the structure of these programs in each state. In 2016, the Northwest Health Plan provided coverage and services valued at $47.1 million (at cost, net of $121.1 million of related revenues) for members and nonmembers in programs sponsored by the federal and state governments. As of December 2016, KFHP-NWs membership in Medicaid programs was approximately 40,000. The Affordable Care Act has had a far-reaching impact on the landscape of government-sponsored programs. These options have become a key source of health coverage for a significant portion of the American population. KFHP-NW has responded to this challenge by developing organizational strategies to enable individuals whose coverage is changing due to personal or financial circumstances to enroll in a Medicaid program offered by KFHP-NW. Realized and anticipated growth in the organizations Medicaid offerings closely aligns with and supports KFHP-NWs core mission, tax exempt status, credibility in state and federal policy arenas, and community health needs focusing on access to care. To better cope with the expansion of KFHP-NWs Medicaid program, a Medicaid Assistance Center (MAC) was opened for operation in 2014. Center representatives provide specialized enrollment services by assisting callers in understanding Medicaid in their state and the qualifications to enroll in Medicaid with KFHP-NW, with an emphasis on availability of bilingual support. A proactive follow-up process has been implemented to nurture a good foundational relationship with those prospects that elect to receive communications.
A.2.1. Medicaid Programs Northwest Health Plan participated in three Medicaid managed care programs in Oregon and Washington as well as a fee-for-service provider for patients who have no formal affiliation with KFHP-NW. In 2016, KFHP-NW expended approximately $49.1 million (at cost, net of $119.1 million of related revenues) to subsidize care under Medicaid. In Oregon, Health Plan partners with the Health Share of Oregon as a fully capitated, risk-accepting entity and Trillium Community Health as a fee for service provider. In Washington, Health Plan participates as a fully capitated contractor of Molina Healthcare of Washington. The following describe the programs and target populations. A.2.1.1. Medicaid Managed Care Programs A.2.1.1.1. Health Share of Oregon Northwest Health Plan is a direct contractor with Health Share of Oregon under a Provider Care Organization contract to deliver primary and specialty care paid by the state. All reporting, analysis, auditing, and member administration is performed by KFHP-NW as a Managed Care Organization. As a result, KFHP-NW is engaged in policy development, program structure, and technical capabilities in partnership with the Health Share of Oregon. Currently, Northwest Health Plan, along with other regional health care providers, Tuality Healthcare, Care Oregon, and Providence Health Services, is a risk-accepting entity and a founding partner of Health Share of Oregon for Multnomah, Clackamas, and Washington counties. This is the largest Coordinated Care Organization in the state. A.2.1.1.2. Trillium Community Health With the establishment of Coordinated Care Organizations in the State of Oregon, KFHP-NW joined other health plans as a risk-accepting entity and founding partner in the management of Medicaid managed care contracts. KFHP-NW provides service for individuals with Medicaid or other government sponsored programs in the fee-for-service setting for individuals/populations not enrolled in managed care in Lane County. A.2.1.1.3. Molina Healthcare of Washington Washington Apple Health program is a Medicaid program offered by Molina Healthcare for low-income individuals that meet eligibility requirements for Medicaid. It is a fully-capitated state program managed by the Washington State Health Care Authority (HCA). Northwest Health Plan provides services to eligible participants who reside in either Clark or Cowlitz counties through a subcontract with Molina Healthcare. A.2.1.1.4. Medicaid Dental Program Kaiser Foundation Health Plan of the Northwest has known for 40 years that dental care is a crucial component of total health. Research has shown that dental care combined with medical care improves health outcomes for members and the bottom line for insurers. Northwest Health Plans actuarial team estimated savings of approximately $11 million for diabetic and cardiac patients who utilize dental services compared to those without Health Plan dental. Dental diseases account for between 5 percent and 10 percent of total health care expenditures. This exceeds the cost of treating cardiovascular disease, cancer, and osteoporosis. A.2.1.2. Medicaid Fee-for-Service Northwest Health Plan contributed $4.3 million (at cost, net of $3.7 million of related revenues) in subsidized care to Medicaid Fee-for-Service patients during 2016. These patients have no formal membership affiliation with KFHP-NW. When a Medicaid nonmember receives services from Kaiser Permanente providers at hospitals or outpatient services as a result of hospital visit follow-up, these expenses are captured as professional and non-professional losses under the Medicaid nonmember program. A.2.1.3. Child Health Insurance Program (CHIP) In both Oregon and Washington, KFHP-NW participates as a provider in the states Child Health Insurance Program. The program provides health insurance to children whose family income is between 200 percent and 300 percent of the federal poverty level, and who are not eligible for Medicaid. Subsidies are provided on a sliding scale based on income. In both states, the program is governed by the Medicaid contract, and offers the same benefits. Northwest Health Plan incurred net losses of $7.9 million (at cost, net of $15.7 million of related revenues) under this program in 2016. A.2.2. Other Government Programs The Oregon Transitional Reinsurance Program supplements the federal program by helping to pay for high claims costs associated with individuals in previous high risk programs. The Washington Medical Insurance Pool provides coverage to individuals who were enrolled in the prior insurance pool program. Legislation allows the states to spread a portion of the expenses for enrollees across the pools of individuals who are insured wholly or in-part by all health insurers, re-insurers, and stop-loss carriers licensed in each state. Northwest Health Plan received net reinsurance recoveries of $2 million under these programs in 2016. A.3. Care and Coverage Programs and Services A.3.1. Susan G. Komen of Oregon & SW Washington KPHP of the Northwest has partnered with Susan G. Komen of Oregon & Southwest Washington in their Poder y Vida Initiative to address the high rates late stage breast cancer diagnosis in the Latina community in the NW region. This initiative involves multiple community partners, including several safety net clinics which employ Latina Community Health Workers (Promotoras) who conduct targeted outreach, education and provide navigation and support for Latina women to access breast cancer screening and treatment. This multi-year initiative aims to increase screening rates, improve knowledge and awareness in the Latino community around breast health and reduce late stage diagnoses. KFHP-NW donated mammography and follow up services for 700 women through the Susan G. Komen of Oregon and SW Washington initiative in 2016. A.3.2. Free Dental Care Days This is a partnership with various organizations and school districts to provide much needed dental care to adults and children with limited incomes and no dental insurance. Dental offices create schedules for a number of adults and children on a day the office is closed to normal operations (generally on Saturdays). Permanente Dental Associates (PDA) dentists volunteer their services on these days. Free Dental Care Days served approximately 100 people in 2016. Note: Kaiser Foundation Health Plan of the Northwest recognized no significant financial investments in the following Streams of Work during 2016: B. Community Health Initiatives (CHI) C. Safety Net Partnerships D. Developing and Disseminating Knowledge
E. Other Community Benefit Investments During 2016, Northwest Health Plan spent $2.0 million to support Community Benefit activities and programs beyond the national streams of work. This included the administrative expenses of a Community Benefit department dedicated to supporting regional Community Benefit programs and services and coordinating related initiatives.
F. Environmental Stewardship Poor environmental quality contributes to disease, illness and economic insecurity. Kaiser Permanente has therefore committed itself to protecting and improving the natural environment as a key component of our social mission to improve the health of the communities we serve. To fulfill this commitment, Kaiser Permanente maintains a governance structure for environmental stewardship that enables the organization to continuously improve its environmental performance. This structure includes clearly defined roles, responsibilities, plans and routines, and has resulted in five organization-wide focus areas that have been selected based on their ability to have the most impact on the environmental forces that shape environmental and human health. - Addressing causes of climate change - Promoting sustainable farming and food choices - Reducing, reusing, and recycling to eliminate waste - Buying products and materials that do not contain chemicals or concern - Conserving water In each of these focus areas, KFHP-NW has established ambitious goals (including a target to reduce total greenhouse gas emissions by 30% by 2020, compared to a 2008 baseline), implemented initiatives, achieved measurable improvements, and regularly reported progress to the board of directors, staff, and the general public. F.1. Performance Metrics During 2016, key performance indicators for Kaiser Foundation Health Plan of the Northwest included: F.1.1. Medical product categories for which at least 99% of purchased products were free of harmful polyvinyl chloride (PVC) and bis(2-ethylhexyl) phthalate (DEHP) chemicals included: 1. Breast pumps; 2. Enteral nutrition products; 3. Exam gloves. Medical product categories for which at least 95% of purchased products were free of harmful DEHP included: 1. Infusion pumps, sets, and solutions; and 2. Vascular catheters. F.1.2. Purchased over 7 million kilowatt-hours of Clean Wind renewable power. F.1.3. Improved our energy use intensity (kBtu/rentable square foot) by 8% compared to our 2010 baseline year. F.1.4. Responsibly reused, recycled or composted over 1,700 tons of materials. F.1.5. Improved our water use intensity (gallons/rentable square foot) by 9% since our 2013 baseline year.
FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED MEDICAL SERVICE TOTAL FEES:XXX-XX-XXXX
FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED OTHER NON-MEDICAL SV TOTAL FEES:70982048
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2019


Additional Data


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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
2019
Open to Public Inspection
Name of the organization
KAISER FOUNDATION HEALTH PLAN
OF THE NORTHWEST
Employer identification number

93-0798039
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 Health Plan Inc
ONE KAISER PLAZA SUITE 15L

OAKLAND,CA94612
94-1340523 		HEALTH CARE CA 501(c)(3) 10 NA
 
 
No
(2)Kaiser Foundation Health Plan of CO Inc
ONE KAISER PLAZA SUITE 15L

OAKLAND,CA94612
84-0591617 		HEALTH CARE CO 501(c)(3) 10 KFHP INC
 
Yes
 
(3)Kaiser Foundation Health Plan of GA Inc
ONE KAISER PLAZA SUITE 15L

OAKLAND,CA94612
58-1592076 		HEALTH CARE GA 501(c)(3) 10 KFHP INC
 
Yes
 
(4)Kaiser Foundation Health Plan of the MAS
ONE KAISER PLAZA SUITE 15L

OAKLAND,CA94612
52-0954463 		HEALTH CARE MD 501(c)(3) 10 KFHP INC
 
Yes
 
(5)Kaiser Foundation Hospitals
ONE KAISER PLAZA SUITE 15L

OAKLAND,CA94612
94-1105628 		HEALTH CARE CA 501(c)(3) 3 na
 
 
No
(6)Camp Bowie Service Center
ONE KAISER PLAZA SUITE 15L

OAKLAND,CA94612
94-3299123 		ADMIN CA 501(c)(3) 12 - I KFHP INC
 
Yes
 
(7)Kaiser Health Alternatives
ONE KAISER PLAZA SUITE 15L

OAKLAND,CA94612
93-0954562 		HEALTH CARE OR 501(c)(3) 10 KFHP INC
 
Yes
 
(8)Kaiser Hospital Asset Management Inc
ONE KAISER PLAZA SUITE 15L

OAKLAND,CA94612
94-3299125 		ASSET MGMT CA 501(c)(3) 12 - I KFH
 
Yes
 
(9)Kaiser Health Plan Asset Management Inc
ONE KAISER PLAZA SUITE 15L

OAKLAND,CA94612
94-3299124 		ASSET MGMT CA 501(c)(3) 12 - I KFHP INC
 
Yes
 
(10)Lokahi Assurance Ltd
ONE KAISER PLAZA SUITE 15L

OAKLAND,CA94612
91-2171891 		wc placement HI 501(c)(3) 12 - I KFHP INC
 
Yes
 
(11)Kaiser Fdn Health Plan of Washington
ONE KAISER PLAZA SUITE 15L

OAKLAND,CA94612
93-0480268 		health care WA 501(c)(3) 12 - I KFHP INC
 
Yes
 
(12)1800 Harrison Foundation
ONE KAISER PLAZA SUITE 15L

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

OAKLAND,CA94612
31-1779500 		FINANCING CA 501(c)(3) 12 - I KFH
 
Yes
 
(14)Kaiser Permanente School of Medicine Inc
ONE KAISER PLAZA SUITE 15L

Oakland,CA94612
81-4053028 		Medical Edu CA 501(c)(3) 2 KFH
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



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

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




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



 		(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) Kaiser Permanente International

ONE KAISER PLAZA 15L
OAKLAND,CA94612
94-3245176 		CONSULTING CA NA
  		C CORP       Yes  
(2) Kaiser Permanente Insurance Company

ONE KAISER PLAZA 15L
OAKLAND,CA94612
94-3203402 		INSURANCE CA NA
  		C CORP       Yes  
(3) Kaiser Properties Services Inc

ONE KAISER PLAZA 15L
OAKLAND,CA94612
94-3259432 		REAL ESTATE CA NA
  		C CORP       Yes  
(4) Oak Tree Assurance Ltd

ONE KAISER PLAZA 15L
OAKLAND,CA94612
03-0329760 		INSURANCE VT NA
  		C CORP       Yes  
(5) Kaiser Colorado Holdings

One Kaiser Plaza 15l
Oakland,CA94612
81-4691154 		health care CO na
  		c corp       Yes  




Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
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
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
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
Yes
 
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
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
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 252,761,298 PER AGREEMENT
(2) KAISER FOUNDATION HEALTH PLAN INC

 M 344,510,884 PER AGREEMENT
(3) KAISER FOUNDATION HEALTH PLAN INC

 P 72,677,952 PER AGREEMENT
(4) KAISER FOUNDATION HEALTH PLAN INC

 Q 28,146,289 PER AGREEMENT
(5) KAISER FOUNDATION HEALTH PLAN INC

 R 756,475,562 PER AGREEMENT
(6) KAISER FOUNDATION HEALTH PLAN INC

 S 1,104,431,894 PER AGREEMENT
(7) KAISER FOUNDATION HOSPITALS

 B 175,000,000 PER AGREEMENT
(8) KAISER FOUNDATION HOSPITALS

 I 2,739,819 PER AGREEMENT
(9) KAISER FOUNDATION HOSPITALS

 L 1,279,241 PER AGREEMENT
(10) KAISER FOUNDATION HOSPITALS

 M 1,094,936,970 PER AGREEMENT
(11) KAISER FOUNDATION HOSPITALS

 P 1,595,607,463 PER AGREEMENT
(12) KAISER FOUNDATION HOSPITALS

 Q 354,382,774 PER AGREEMENT
(13) KAISER FOUNDATION HEALTH PLAN OF COLORADO

 L 514,334 PER AGREEMENT
(14) KAISER FOUNDATION HEALTH PLAN OF COLORADO

 M 486,952 PER AGREEMENT
(15) KAISER FOUNDATION HEALTH PLAN OF COLORADO

 Q 290,904 PER AGREEMENT
(16) KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC

 M 176,981 PER AGREEMENT
(17) KAISER FOUNDATION HEALTH PLAN OF THE MAS INC

 L 232,142 PER AGREEMENT
(18) KAISER FOUNDATION HEALTH PLAN OF THE MAS INC

 M 406,436 PER AGREEMENT
(19) KAISER FOUNDATION HEALTH PLAN OF THE MAS INC

 Q 320,501 PER AGREEMENT
(20) CAMP BOWIE SERVICE CENTER

 L 21,737,215 PER AGREEMENT
(21) CAMP BOWIE SERVICE CENTER

 M 91,387 PER AGREEMENT
(22) CAMP BOWIE SERVICE CENTER

 P 23,138,360 PER AGREEMENT
(23) CAMP BOWIE SERVICE CENTER

 Q 1,337,694 PER AGREEMENT
(24) KAISER PERMANENTE INSURANCE COMPANY

 L 6,212,712 PER AGREEMENT
(25) KAISER PERMANENTE INSURANCE COMPANY

 M 53,088 PER AGREEMENT
(26) LOKAHI ASSURANCE LTD

 L 7,538,209 PER AGREEMENT
(27) LOKAHI ASSURANCE LTD

 M 19,632,621 PER AGREEMENT
(28) LOKAHI ASSURANCE LTD

 Q 13,838,714 PER AGREEMENT
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(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) 2019
Schedule R (Form 990) 2019
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2019

Additional Data


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