Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (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 | |||||
| (A)
WEST PENN ALLEGHENY HEALTH SYSTEM INC |
453674924 | 3 | Yes | 3,348,213 | 0 | |
| (B)
CANONSBURG GENERAL HOSPITAL |
251737079 | 3 | Yes | 94,901 | 0 | |
| (C)
ALLE-KISKI MEDICAL CENTER |
251875178 | 3 | Yes | 227,642 | 0 | |
| (D)
JEFFERSON REGIONAL MEDICAL CENTER |
251260215 | 3 | Yes | 476,032 | 0 | |
|
Total 4
|
4,146,788 | 0 | ||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 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 | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 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..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART IV, SECTION A, LINE 6 | Highmark Health (HH) exists to support the charitable mission of the Allegheny Health Network. Refer to Schedule O for information on the Allegheny Health Network and HH's role in supporting its mission. HH provides services to Highmark Inc. Highmark Inc. is a Pennsylvania nonprofit corporation and an independent licensee of the Blue Cross and Blue Shield Association. HH is the sole voting member of Highmark Inc. |
| SCHEDULE A, PART IV, SECTION B, LINE 1 | THE HIGHMARK HEALTH (HH) BOARD BROADLY REPRESENTS THE COMMUNITY SERVED BY THE HEALTH SYSTEM. THE HH BOARD IS A SELF PERPETUATING BOARD; THE HH BOARD MEMBERS WILL SELECT THEIR SUCCESSORS. |
| SCHEDULE A, PART I - INFORMATION ABOUT SUPPORTED ORGANIZATIONS | HIGHMARK HEALTH PROVIDED ADMINISTRATIVE AND OTHER SERVICES TO THE SUPPORTED ORGANIZATIONS LISTED. |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| MISSION, VISION AND VALUES | FORM 990, PART III, LINE 1 MISSION OUR MISSION IS TO CREATE A REMARKABLE HEALTH EXPERIENCE, FREEING PEOPLE TO BE THEIR BEST. VISION OUR VISION IS A WORLD WHERE EVERYONE EMBRACES HEALTH. VALUES PEOPLE MATTER - EVERY PERSON CONTRIBUTES TO OUR SUCCESS. WE STRIVE FOR AN INCLUSIVE CULTURE, REGARDING PEOPLE AS PROFESSIONALS AND RESPECTING INDIVIDUAL DIFFERENCES WHILE FOCUSING ON THE COLLECTIVE WHOLE. STEWARDSHIP - WORKING TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE AND WISELY MANAGING THE ASSETS WHICH HAVE BEEN ENTRUSTED TO OUR CARE. TRUST - EARNING TRUST BY DELIVERING ON OUR COMMITMENTS AND LEADING BY EXAMPLE. INTEGRITY - COMMITTING TO THE HIGHEST STANDARDS ENCOMPASSING EVERY ASPECT OF OUR BEHAVIOR INCLUDING HIGH MORAL CHARACTER, RESPECT, HONESTY AND PERSONAL RESPONSIBILITY. CUSTOMER-FOCUSED COLLABORATION - BECAUSE NO ONE PERSON HAS ALL THE ANSWERS, WE ACTIVELY SEEK TO COLLABORATE WITH EACH OTHER TO ACHIEVE THE RIGHT OUTCOMES FOR OUR CUSTOMERS. COURAGE - EMPOWERING EACH OTHER TO ACT IN A PRINCIPLED MANNER AND TO TAKE APPROPRIATE RISKS TO DO WHAT IS RIGHT TO FULFILL OUR MISSION. INNOVATION - COMMITTING TO CONTINUOUS LEARNING AND EXPLORING NEW, BETTER, AND CREATIVE WAYS TO ACHIEVE OUR VISION. EXCELLENCE - BEING ACCOUNTABLE FOR CONSISTENTLY EXCEEDING THE EXPECTATIONS OF THOSE WE SERVE. |
| BUSINESS RELATIONSHIPS | FORM 990, PART VI, LINE 2 THE FOLLOWING BOARD MEMBERS HAVE A BUSINESS RELATIONSHIP THROUGH THEIR CONNECTION OF SERVING TOGETHER ON THE BOARD OF RELATED TAXABLE NON-PROFIT ORGANIZATIONS: JOSEPH GUYAUX, DAVID BLANDINO, M.D., VICTOR ROQUE, THOMAS DONAHUE, STEVEN HOFFMAN, CPA, GREGORY JORDAN, ESQ., DAVID MALONE, DAVID MATTER, SUSAN SHOVAL, AND DAVID HOLMBERG. DAVID HOLMBERG AND DENNIS CRONIN HAVE A BUSINESS RELATIONSHIP. |
| REVIEW PROCESS | FORM 990, PART VI, LINE 11B THE HIGHMARK HEALTH (HH) IRS FORM 990 WAS PREPARED BY ITS EXTERNAL TAX ADVISORS, PRICEWATERHOUSECOOPERS LLP AND REVIEWED BY THE HH TAX DEPARTMENT, SENIOR MANAGEMENT OF THE ORGANIZATION AND THE AUDIT AND COMPLIANCE COMMITTEE. BEFORE FILING THE TAX RETURN WITH THE INTERNAL REVENUE SERVICE, A FINAL COPY WAS PROVIDED TO ALL MEMBERS OF THE BOARD OF DIRECTORS. |
| CONFLICT OF INTEREST POLICY MONITORING AND ENFORCEMENT | FORM 990, PART VI, SECTION B, LINE 12C HH has a corporate compliance department that monitors and oversees compliance with the Conflict of Interest Policy for all entities within the filing group. The following describes the manner in which the corporate compliance department monitors and oversees compliance with the conflict of interest policy: CONFLICT OF INTEREST DISCLOSURE STATEMENTS ARE COMPLETED UPON HIRE/APPOINTMENT AND ON AN ANNUAL BASIS BY ALL BOARD MEMBERS, OFFICERS, KEY EMPLOYEES, SUPERVISORS AND ABOVE, PERSONS WITH PURCHASING AND DECISION MAKING AUTHORITY, AND ANY OTHER EMPLOYEES AS DESIGNATED BY THE COMPLIANCE DEPARTMENT. INDIVIDUALS ARE REQUIRED TO REPORT TO THE COMPLIANCE DEPARTMENT THROUGHOUT THE YEAR IF CHANGES IN CIRCUMSTANCES ARISE THAT MAY GIVE RISE TO A POTENTIAL CONFLICT OF INTEREST OR CHANGE A PREVIOUSLY-DISCLOSED CONFLICT. Upon completion of the above disclosure statement by all applicable individuals, the Corporate Compliance Department reviews all disclosures. Those disclosure statements that require additional information or clarification are contacted by the corporate compliance department requesting such. Once received, the Corporate Compliance Department reviews the information to determine whether a real or potential conflict of interest exists. As applicable, Legal and Senior Management are consulted to determine whether a real or potential conflict of interest exists. When a conflict requires a mitigation plan, the mitigation plan is developed and approved in coordination with the respective responsible senior management. The senior managers are responsible for discussing the mitigation plan with the individual and monitoring compliance with the mitigation plan. A Conflict of Interest/Independence Disclosure Summary Report of all board members, officers, and executive management with reportable disclosures is provided to the Audit and Compliance committee of the Board of HH as well as the Board of Directors of HH. |
| PROCESS USED TO DETERMINE EXECUTIVE COMPENSATION | FORM 990, PART VI, LINES 15A AND 15B THE HH CORPORATE FOLLOWS A PROCESS FOR DETERMINING COMPENSATION FOR EXECUTIVE POSITIONS, (INCLUDING OFFICERS, KEY EMPLOYEES AND OTHER MANAGEMENT POSITIONS), AND ARE COVERED BY THE HH EXECUTIVE COMPENSATION POLICY. THE POLICY WAS APPROVED BY THE HH BOARD OF DIRECTORS. IT IS THE POLICY OF HH MANAGEMENT TO COMPENSATE ITS EXECUTIVES IN ACCORDANCE WITH THE MARKET AND IN RELATION TO THE EXPERIENCE, SERVICE AND ACCOMPLISHMENTS OF THE INDIVIDUAL BOTH PRIOR TO AND DURING THEIR SERVICE WITH HH. THE PERSONNEL AND COMPENSATION COMMITTEE (P&C) RECOMMENDS AND THE HH BOARD APPROVES THE COMPENSATION FOR THE PRESIDENT AND CEO OF HH. THE P&C COMMITTEE APPROVES THE COMPENSATION OF ALL SENIOR EXECUTIVES WHO REPORT DIRECTLY TO THE PRESIDENT AND CEO OF HH, THE COMPENSATION OF THE PRESIDENT AND CEO OF AHN AND THE COMPENSATION OF ALL NON-HOSPITAL SENIOR EXECUTIVES WHO REPORT DIRECTLY TO THE CEO OF AHN. THE P&C COMMITTEE USES COMPARABILITY DATA PROVIDED BY AN INDEPENDENT COMPENSATION CONSULTANT. THE EXTERNAL CONSULTANT PROVIDES A LETTER OF REASONABILITY FOR ALL OFFERS MADE TO NEW EXECUTIVES THAT REPORT TO THE HH CEO, AHN CEO AND THE DIRECT REPORTS OF EACH. EACH P&C COMMITTEE MEMBER VOTING ON A SENIOR EXECUTIVE'S COMPENSATION ARRANGEMENT ENSURES THAT HE OR SHE HAS NO CONFLICT OF INTEREST, INCLUDING THAT HE OR SHE (A) DOES NOT ECONOMICALLY BENEFIT FROM THE PROPOSED EMPLOYMENT; (B) DOES NOT RECEIVE COMPENSATION SUBJECT TO THE APPROVAL OF THE PROPOSED EMPLOYEE; AND (C) HAS NO MATERIAL FINANCIAL INTEREST AFFECTED BY THE TRANSACTION. HH MANAGEMENT, IN COORDINATION WITH THE INDEPENDENT CONSULTANT TO THE HH P&C COMMITTEE OBTAINS APPROPRIATE MARKET COMPARABILITY DATA FOR EACH ENTITY, INCLUDING NATIONALLY PUBLISHED COMPENSATION SURVEYS AND/OR SPECIFIC ORGANIZATION PEER GROUPS, TO PREPARE COMPENSATION RECOMMENDATIONS FOR ALL KEY EXECUTIVES, INCLUDING OFFICERS, KEY EMPLOYEES, AND OTHER DISQUALIFIED PERSONS. RECOMMENDATIONS ARE REVIEWED AND APPROVED BY A COMMITTEE THAT IS INDEPENDENT WITH RESPECT TO THE COMPENSATION PROVIDED TO THE EXECUTIVES. COMPENSATION MAY INCLUDE SEVERAL FORMS OF CASH COMPENSATION, INCLUDING BASE SALARY, PERFORMANCE-BASED INCENTIVE COMPENSATION, AND A COMPETITIVE EMPLOYEE BENEFITS PROGRAM. BASE SALARY IS THE FIXED ELEMENT OF COMPENSATION INTENDED TO ALIGN WITH EACH EXECUTIVE'S ROLE, RESPONSIBILITIES, OVERALL PERFORMANCE AND OTHER CONTRIBUTIONS. INCENTIVE COMPENSATION IS USED TO PROVIDE VARIABLE, OR "AT RISK" COMPENSATION BASED ON THE PERFORMANCE OF BOTH THE EXECUTIVE AND THE ORGANIZATION. EXECUTIVES CAN EARN INCENTIVE COMPENSATION ONLY IF THE ORGANIZATION ACHIEVES CERTAIN PRE-DETERMINED FINANCIAL GOALS. THE PLANS ARE INTENDED TO HOLD EXECUTIVES ACCOUNTABLE FOR ACHIEVING PERFORMANCE THAT IS CONSISTENT WITH THE SHORT-TERM AND LONG-TERM GOALS AND OBJECTIVES OF THE ORGANIZATION. HH FOLLOWS THE REQUIREMENT IN THE REGULATIONS TO COMPLY WITH THE REBUTTABLE PRESUMPTION OF THE REASONABLENESS OF COMPENSATION. |
| PUBLIC AVAILABILITY OF ORGANIZATIONAL DOCUMENTS | FORM 990, PART VI, LINE 19 HH DOES NOT MAKE ITS GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC. THE AUDITED FINANCIAL STATEMENTS OF HH ARE INCLUDED IN A CONSOLIDATED FINANCIAL STATEMENT FOR THE HEALTH SYSTEM. IT IS AVAILABLE UPON REQUEST AND APPROVAL BY THE CFO OF HH. HH HAS ADOPTED A CONFLICT OF INTEREST POLICY THAT IS UNIFORMLY APPLIED TO ALL HH ORGANIZATIONS. THIS POLICY IS NOT MADE AVAILABLE TO THE PUBLIC. |
| OTHER CHANGES IN NET ASSETS OR FUND | FORM 990, PART XI, LINE 9 EQUITY TRANSFERS FROM SUBSIDIARIES $47,428,986 OTHER - GUIDANCE ADOPTION $42,082 - - - - - - - TOTAL $47,471,068 |
| Software ID: | |
| Software Version: |