| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS: THE ORGANIZATION HAS ONE CORPORATE MEMBER, COMMUNITY HEALTH NETWORK OF WASHINGTION (CHNW), A RELATED 501(C)(4) TAX EXEMPT ENTITY. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD OF DIRECTORS OF THE SOLE CORPORATE MEMBER, COMMUNITY HEALTH NETWORK OF WASHINGTON (CHNW), ELECTS THE CHPW BOARD OF DIRECTORS. EACH MEMBER OF THE CHPW BOARD OF DIRECTORS MUST MEET THE QUALIFICATIONS TO BE A CHNW BOARD MEMBER. DURING 2024, ALL CHPW BOARD MEMBERS SERVED ON THE CHNW BOARD. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING POWERS RELATED TO CHPW ARE RESERVED TO CHNW BY ITS BYLAWS: A) AMENDMENT OF THE ARTICLES OF INCORPORATION, B) AMENDMENT TO THE BYLAWS, C) REMOVAL OF ONE OR MORE DIRECTORS FROM THE BOARD, D) APPROVAL OF ARTICLES OF MERGER, E) APPROVAL OF THE SALE OR LEASE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF CHPW OTHER THAN IN THE ORDINARY COURSE OF BUSINESS, AND F) APPROVAL OF THE VOLUNTARY DISSOLUTION OF CHPW. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 AND ALL REQUIRED SCHEDULES ARE REVIEWED BY THE VP OF FINANCE, CHIEF FINANCIAL OFFICER, AND CHIEF EXECUTIVE OFFICER. THE CHIEF FINANCIAL OFFICER THEN PROVIDES THE 990 TO THE CHPW FINANCE COMMITTEE AND THE CHPW BOARD OF DIRECTORS FOR REVIEW BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL BOARD MEMBERS, CORPORATE OFFICERS, AND EMPLOYEES AT THE DIRECTOR LEVEL AND ABOVE ARE REQUIRED TO ANNUALLY DISCLOSE POTENTIAL CONFLICTS OF INTEREST. WITH RESPECT TO BOARD MEMBERS, POTENTIAL CONFLICTS ARE DISCLOSED PRIOR TO DELIBERATION; IF AN ACTUAL CONFLICT EXISTS, THE INDIVIDUAL WITH THE CONFLICT WILL NOT PARTICIPATE AND IS ASKED TO LEAVE THE MEETING DURING FINAL DELIBERATION AND VOTE. WITH RESPECT TO EMPLOYEES, INCLUDING CORPORATE OFFICERS AND EMPLOYEES AT THE DIRECTOR LEVEL AND ABOVE, POTENTIAL CONFLICTS ARE GOVERNED BY THE ORGANIZATION'S CONFLICT OF INTEREST POLICY; ACTUAL OR POTENTIAL CONFLICTS MUST BE DISCLOSED TO THE HUMAN RESOURCES DEPARTMENT OR A CORPORATE OFFICER. THE COMPLIANCE OFFICER, IN COOPERATION WITH HUMAN RESOURCES, WILL REVIEW THE CONFLICT AND ADVISE THE EMPLOYEE WITH A POTENTIAL CONFLICT CONCERNING ANY LIMITATIONS THEY MUST OBSERVE IN REGARDS TO THE CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CHPW CEO COMPENSATION IS SET BY THE EXECUTIVE COMMITTEE OF THE CHPW BOARD OF DIRECTORS BASED UPON INDEPENDENT THIRD PARTY COMPENSATION INFORMATION AND PROFESSIONAL OPINION. AT LEAST ANNUALLY, THE CHPW HUMAN RESOURCES DEPARTMENT REVIEWS COMPENSATION OF ALL EMPLOYEES (INCLUDING EMPLOYED OFFICERS AND KEY EMPLOYEES). THE CHPW HUMAN RESOURCES DEPARTMENT UTILIZES SEVERAL INDEPENDENT THIRD PARTY COMPENSATION SURVEYS TO MAKE RECOMMENDATIONS ABOUT EMPLOYED OFFICER AND KEY EMPLOYEE COMPENSATION. UTILIZING THAT INFORMATION, THE CHPW CEO SETS THE COMPENSATION FOR EMPLOYED OFFICERS AND KEY EMPLOYEES. |
| FORM 990, PART VI, SECTION C, LINE 19 | COPIES OF GOVERNANCE DOCUMENTS, THE CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE BY REQUEST MADE TO THE CORPORATE OFFICES AT 1111 3RD AVENUE, SUITE 400 SEATTLE, WA 98101 OR BY FAXING A REQUEST TO (206) 521-8834. ALSO, THE STATUTORY AUDITED FINANCIAL STATEMENTS ARE POSTED ON THE OFFICE OF INSURANCE COMMISSIONER WEBSITE. |
| FORM 990, PART VII: | ALL EMPLOYEES ARE PAID THROUGH COMMUNITY HEALTH PLAN OF WASHINGTON (CHPW). SALARIES REPORTED AS EXPENSES ON THE NETWORK'S STATEMENT OF FUNCTIONAL EXPENSES ARE REPORTED THROUGH CHPW AS A COMMON PAYMASTER. THE FOLLOWING INDIVIDUALS SERVE ON THE BOARD OF COMMUNITY HEALTH PLAN OF WASHINGTON (CHPW) IN CONNECTION WITH THEIR ROLES AS THE CEO, EXECUTIVE DIRECTOR, OR OTHER SENIOR EXECUTIVE OF THE TAX-EXEMPT COMMUNITY HEALTH CENTER OR CLINIC (CHC) MEMBERS OF COMMUNITY HEALTH NETWORK OF WASHINGTON. THESE INDIVIDUALS DO NOT RECEIVE COMPENSATION FOR THEIR BOARD SERVICE; HOWEVER, CHNW PAYS THEIR RESPECTIVE CHC A STIPEND FOR SERVICES ON BOARD COMMITTEES AND REIMBURSEMENT FOR TRAVEL EXPENSES. - JOSEPH EUGENE VESSEY - REGINA BONNEVIE ROGERS (MEDICAL DIRECTOR) - ANGELA MARIA GONZALEZ - AARON GABRIEL WILSON - RHONDA DIANE HAUFF - JENNIFER LYNN KREIDLER-MOSS - BRANDY DIANE TAYLOR - DAVID ELDOR FLENTGE - DESIREE LYN SWEENEY - GAELON BROOK SPRADLEY - JESUS HERNANDEZ - KELLI ANN NOMURA - LISA CORINNE YOHALEM - JEFFREY SPENCER GIBBS (JAN 2024-DEC 2024) - RASHAD ALI COLLINS - SHEILA ANN BERSCHAUER - CHRISTINE SUE TROTTER - JAMES KENNETH COFFEE - JODI SUE JOYCE - KRISTY NEEDHAM - MANUEL IGNACIO NAVARRO - MICHAEL SCOTT MAXWELL |
| FORM 990, PART XI, LINE 9: | CHANGE IN NONADMITTED ASSETS -1,706,018. |
| FORM 990, PART XII, LINE 1: | STATUTORY BASIS |
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