Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THIS ORGANIZATION IS MCLAREN HEALTH PLAN. |
| FORM 990, PART VI, SECTION A, LINE 7A | UNDER MICHIGAN LAW (MCL 500.3511), ONE-THIRD OF THE GOVERNING BODY MUST BE ADULT ENROLLERS OF MCLAREN HEALTH PLAN COMMUNITY, ELECTED BY SUBSCRIBERS/CONTRACT HOLDERS OF MCLAREN HEALTH PLAN COMMUNITY. THE SOLE MEMBER OF MCLAREN HEALTH PLAN COMMUNITY, MCLAREN HEALTH PLAN, INC., MAY APPOINT THE REMAINING TWO-THIRDS OF THE BOARD. |
| FORM 990, PART VI, SECTION A, LINE 7B | DECISIONS BY THE GOVERNING BODY ARE SUBJECT TO THE POWERS OF THE MEMBER. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 IS REVIEWED BY MCLAREN HEALTH PLAN COMMUNITY'S PRESIDENT & CEO AND ALSO BY THE CFO PRIOR TO FILING. AS PART OF AN INTEGRATED HEALTH SYSTEM, THE PARENT BOARD ALSO REVIEWS THE FORM 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH MCLAREN HEALTH PLAN COMMUNITY BOARD MEMBER, OFFICER AND SENIOR MANAGEMENT EXECUTIVE COMPLETES THE MCLAREN HEALTH PLAN COMMUNITY CONFLICT OF INTEREST DISCLOSURE FORM ANNUALLY. THE BOARD CHAIR AND PRESIDENT/CEO REVIEW ALL COMPLETED FORMS TO IDENTIFY ANY POTENTIAL CONFLICTS. ANY IDENTIFIED POTENTIAL CONFLICT IS INVESTIGATED AND RAISED WITH THE INDIVIDUAL, AS APPROPRIATE, TO RESOLVE THE CONFLICT OR DETERMINE IF ANY ACTION IS NEEDED, UP TO AND INCLUDING, POSSIBLE REMOVAL FROM THE BOARD, OR OFFICER/SENIOR MANAGEMENT POSITION. ANY IDENTIFIED CONFLICTS ARE REPORTED TO THE FULL BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 15 | TO ENSURE A FAIR, COMPETITIVE AND LEGALLY COMPLIANT METHOD OF ADMINISTERING COMPENSATION, MHPC USES INDEPENDENT COMPENSATION STUDIES AND SURVEY DATA TO ESTABLISH THE COMPENSATION STRUCTURE FOR THE MHPC CEO AND OFFICERS. COMPENSATION FOR THE CEO AND OFFICERS ARE REVIEWED ANNUALLY. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE PROVIDED UPON REQUEST. THE FINANCIAL STATEMENTS ARE AVAILABLE ON THE MICHIGAN DIFS (FORMERLY OFIR) WEBSITE. |
| FORM 990, PART XI, LINE 9: | CHANGE IN NONADMITTED ASSETS -50,456. CONTRIBUTED SURPLUS FROM PARENT 22,500,000. |
| FORM 990, PART XII, LINE 1: | THE ORGANIZATION OBTAINED SEPARATE, INDEPENDENT AUDITED FINANCIAL STATEMENT FOR THE TAX YEAR ON A OCBOA STATUTORY ACCOUNTING METHOD. |
| FORM 990, PART XII, LINE 2C: | THERE HAS BEEN NO CHANGE IN THE OVERSIGHT OR SELECTION PROCESS FROM PRIOR YEAR. |
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