TY 2024 Form 990

- TIN:

SCHEDULE A
(Form 990)

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.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2024

Open to Public
Inspection

Name of the organization

Highmark Health

Employer identification number

45-3674900

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................6

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)
(i) Name of supported organization	(ii) EIN		Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(A) WEST PENN ALLEGHENY HEALTH SYSTEM INC	250969492	3	Yes		11,400,634	0
(B) CANONSBURG GENERAL HOSPITAL	251737079	3	Yes		318,916	0
(C) ALLE-KISKI MEDICAL CENTER	251875178	3	Yes		603,649	0
(D) JEFFERSON REGIONAL MEDICAL CENTER	251260215	3	Yes		1,662,187	0
(E) GROVE CITY MEDICAL CENTER	251340370	3	Yes		334,239	0
(F) SAINT VINCENT HEALTH CENTER	250965547	3	Yes		2,237,410	0
Total 6					16,557,035	0

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2024

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)		(a) 2020	(b) 2021	(c) 2022	(d) 2023	(e) 2024	(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)		(a) 2020	(b) 2021	(c) 2022	(d) 2023	(e) 2024	(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

Gross receipts from related activities, etc. (see instructions) ..................

First 5 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

Public support percentage for 2024 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2023 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2024. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2023. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2024. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2023. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

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) 2024

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)		(a) 2020	(b) 2021	(c) 2022	(d) 2023	(e) 2024	(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.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2020	(b) 2021	(c) 2022	(d) 2023	(e) 2024	(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 on 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.)..

First 5 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

Public support percentage for 2024 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2023 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2024 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2023 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2024. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3 % support tests—2023. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2024

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

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.

Yes

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).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

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.

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.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

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.

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.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c 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).

Yes

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?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

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.

Yes

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) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

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.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on 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.

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

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) 2024

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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.

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.

Section C. Type II Supporting Organizations

Yes

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).

Section D. All Type III Supporting Organizations

Yes

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?

Yes

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).

Yes

By reason of the relationship described in line 2 above, 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.

Yes

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

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.

Yes

Did the activities described on line 2a, above 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.

Yes

Parent of Supported Organizations. Answer lines 3a and 3b below.

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?If "Yes" or "No", provide details in Part VI.

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.

Schedule A (Form 990) 2024

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	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 0.015 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 0.035	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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2024

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2024 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2024	(iii) Distributable Amount for 2024
1 Distributable amount for 2024 from Section C, line 6
2 Underdistributions, if any, for years prior to 2024 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2024:
a From 2019.......
b From 2020.......
c From 2021.......
d From 2022.......
e From 2023.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2024 distributable amount
i Carryover from 2019 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2024 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2024 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2024, 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 2024. 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 2025. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2020.....
b Excess from 2021.....
c Excess from 2022.....
d Excess from 2023.....
e Excess from 2024.....

Schedule A (Form 990) (2024)

Schedule A (Form 990) 2024

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, Part IV, Section A, Line 5a Added, Substituted, or Removed Sup. Org.	During 2024, the Highmark Health Board of Directors approved amendments to the organization's governing documents to include Saint Vincent Health Center (EIN: 25-0965547) and Grove City Medical Center (EIN: 25-1340370) as supported organizations. These additions were made to advance Highmark Health's mission of supporting these organizations' charitable purposes through strategic, operational, and administrative leadership. The authority for these actions is established within the organization's governing document, and the changes were enacted through formal amendments duly approved by the Board. Additionally, Saint Vincent Health System (EIN: 25-1406710) was removed from the list of supported organizations, as it does not operate a hospital and does not meet the established criteria for a supported organization.
Schedule A, Part IV, Section A, Line 6 Support to other supported orgs	HIGHMARK HEALTH IS THE SOLE MEMBER OF ALLEGHENY HEALTH NETWORK AND THE SOLE VOTING MEMBER OF HIGHMARK INC. HIGHMARK HEALTH EXISTS TO SUPPORT THE CHARITABLE MISSION OF ALLEGHENY HEALTH NETWORK. REFER TO SCHEDULE O FOR HIGHMARK HEALTH'S ROLE IN SUPPORTING ALLEGHENY HEALTH NETWORK. HIGHMARK HEALTH ALSO PROVIDES CERTAIN SYSTEM-WIDE ADMINISTRATIVE SERVICES TO HIGHMARK INC. HIGHMARK INC. IS A PENNSYLVANIA NONPROFIT CORPORATION AND AN INDEPENDENT LICENSEE OF THE BLUE CROSS AND BLUE SHIELD ASSOCIATION.
Schedule A, Part IV, Section D, Line 3 Supp. Org. Have Significant Voice In Investment Policies	MANY OF THE SUPPORTED ORGANIZATIONS' BOARD MEMBERS ALSO SERVE ON HIGHMARK HEALTH'S BOARD. THE OVERLAP OF DIRECTORS AND OFFICERS, AS WELL AS THE STRUCTURAL RELATIONSHIP OF THE ENTITIES, CAUSES THE SUPPORTED ORGANIZATIONS TO HAVE A SIGNIFICANT VOICE IN THE USE OF THE INCOME AND ASSETS OF HIGHMARK HEALTH.
Schedule A, Part IV, Section E, Line 2a Org. Activities Directly Further The Exempt Purposes	HIGHMARK HEALTH PROVIDES STRATEGIC, OPERATIONAL, AND ADMINISTRATIVE LEADERSHIP TO ITS SUPPORTED ORGANIZATIONS TO ENABLE THEM TO EXECUTE ON THEIR CHARITABLE MISSIONS. IF HIGHMARK HEALTH DID NOT PROVIDE THESE ACTIVITIES, EACH SUPPORTED ORGANIZATION WOULD HAVE TO UNDERTAKE THESE ACTIVITIES THEMSELVES.
Schedule A, Part IV, Section E, Line 2b Activities That One Or More Supp. Org. Engaged In	HIGHMARK HEALTH PROVIDES STRATEGIC, OPERATIONAL, AND ADMINISTRATIVE LEADERSHIP TO ITS SUPPORTED ORGANIZATIONS, INCLUDING THE PROVISION OF FINANCIAL, LEGAL, HUMAN RESOURCES, GOVERNMENT RELATIONS, AND PUBLIC RELATIONS SERVICES TO ITS SUPPORTED ORGANIZATIONS. IF HIGHMARK HEALTH DID NOT ENGAGE IN AND PROVIDE THE STRATEGIC AND ADMINISTRATIVE ACTIVITIES FOR OR ON BEHALF OF ITS SUPPORTED ORGANIZATIONS, EACH SUPPORTED ORGANIZATION WOULD UNDERTAKE THESE ACTIVITIES THEMSELVES SO THEY COULD CONTINUE TO OPERATE AND ACHIEVE THEIR CHARITABLE MISSIONS.

Schedule A (Form 990) 2024

Additional Data

Software ID:	24020961
Software Version:	2024v5.1

- TIN:

SCHEDULE C
(Form 990)

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

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Complete if the organization is described below. 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

2024

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
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Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
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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

Highmark Health

Employer identification number

45-3674900

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... right arrow

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... right arrow

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ right arrow

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... right arrow

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

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.

Cat. No. 50084S

Schedule C (Form 990) 2024

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 right arrow

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check right arrow

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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? ...................................................................................................................	Yes No

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) 2021	(b) 2022	(c) 2023	(d) 2024	(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) 2024

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

(b)

Amount

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:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Yes

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Yes

877,233

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Total. Add lines 1c through 1i ....................................................................................................

877,233

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

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

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

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."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	HIGHMARK HEALTH ENGAGES IN LIMITED ADVOCACY WITH FEDERAL, STATE, AND LOCAL ELECTED OFFICIALS ON HEALTHCARE LEGISLATION IMPACTING OUR ORGANIZATION AND THE COMMUNITIES WE SERVE.

Schedule C (Form 990) 2024

Additional Data

Software ID:	24020961
Software Version:	2024v5.1

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SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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.
right arrow

Attach to Form 990.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

Open to Public Inspection

Name of the organization

Highmark Health

Employer identification number

45-3674900

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 ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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 July 25, 2006, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year right arrow

Number of states where property subject to conservation easement is located right arrow

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

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)? .............................

Yes No

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.

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.

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 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

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:

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) (Rev. 1-2025)

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

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 ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment right arrow

Permanent endowment right arrow

Term endowment right arrow

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

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 .....
b	Buildings ....
c	Leasehold improvements	665,243	203,647	461,596
d	Equipment ....	69,364,598	53,250,834	16,113,764
e	Other .....	377,567,474	215,163,024	162,404,450
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				178,979,810

Schedule D (Form 990) (Rev. 1-2025)

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)INVESTMENT IN AFFILIATES				282,839,505
(2)INTERCOMPANY RECEIVABLES				71,024,932
(3)457B PLAN ASSETS				2,166,132
(4)ACCRUED INTEREST				200,576
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				356,231,145

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
Federal Income Taxes
DEFERRED COMPENSATION	14,049,969
EXCISE TAXES PAYABLE	2,500,000






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	16,549,969
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) (Rev. 1-2025)

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	0
e	Add lines 2a through 2d .....................			2e	0
3	Subtract line 2e from line 1..................			3	0
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	0
c	Add lines 4a and 4b....................			4c	0
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	0

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	0
e	Add lines 2a through 2d....................			2e	0
3	Subtract line 2e from line 1...................			3	0
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	0
c	Add lines 4a and 4b.....................			4c	0
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	0

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 XI INCLUSION IN CONSOLIDATED AUDITED FINANCIAL STATEMENT

HIGHMARK HEALTH DOES NOT ISSUE INDEPENDENT AUDITED FINANCIAL STATEMENTS. Highmark Health IS A COMPONENT OF A CONSOLIDATED AUDITED FINANCIAL STATEMENT. THE FOLLOWING ANALYSIS REPRESENTS THE RECONCILIATION BETWEEN THE NET INCOME ON THE FINANCIAL STATEMENTS AND THE NET INCOME AS REFLECTED ON IRS FORM 990, PART 1, LINE 19: (REPORTED IN THOUSANDS OF DOLLARS) NET INCOME PER FINANCIAL STATEMENTS $ 61,507 LESS: EQUITY INCOME OF OTHER SUBSIDIARIES $ 47,062 LESS: ADJUSTMENT FOR UNREALIZED INCOME $ 111 NET INCOME PER FORM 990 $ 14,334

Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote

HIGHMARK HEALTH RECORDS UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH FASB ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES. ASC 740 CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES BY DEFINING CRITERIA THAT A TAX POSITON ON AN INDIVIDUAL MATTER MUST MEET BEFORE THAT POSITION IS RECOGNIZED. ASC 740 ALSO PROVIDES GUIDANCE ON MEASUREMENT, CLASSIFICATION, INTEREST AND PENALTIES, DISCLOSURE AND ACCOUNTING IN INTERIM PERIODS. BASED ON AN ANALYSIS PREPARED BY HIGHMARK HEALTH, IT WAS DETERMINED THAT THE APPLICATION OF FASB ASC 740 HAD NO MATERIAL EFFECT ON THE RECORDED ASSETS AND LIABILITIES OF Highmark Health ON A STANDALONE BASIS. AN EXTERNAL AUDIT IS COMPLETED AT A CONSOLIDATED HIGHMARK SYSTEM LEVEL ONLY, INCLUDING HIGHMARK HEALTH AND ALL TAXABLE AND TAX-EXEMPT SUBSIDIARIES.

Schedule D (Form 990) (Rev. 1-2025)

Additional Data

Software ID:	24020961
Software Version:	2024v5.1

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Schedule I
(Form 990)
(Rev. January 2025)

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 instructions and the latest information.

OMB No. 1545-0047

Open to Public
Inspection

Name of the organization
Highmark Health

Employer identification number
45-3674900

Part I

General Information on Grants and Assistance

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? ........................

Yes No

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	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) ALEX'S LEMONADE STAND FOUNDATION 333 E LANCASTER AVE WYNNEWOOD,PA19096	56-2496146	501(c)(3)	10,000	N/A	N/A	GENERAL SUPPORT
(2) ALLEGHENY HEALTH NETWORK 4818 LIBERTY AVENUE PITTSBURGH,PA15224	45-3674924	501(c)(3)	385,000	N/A	N/A	GENERAL SUPPORT
(3) AFRICAN AMERICAN CULTURAL CENTER 980 LIBERTY AVENUE PITTSBURGH,PA15222	47-2697273	501(c)(3)	45,000	N/A	N/A	GENERAL SUPPORT
(4) AYCO CHARITABLE FOUNDATION 25 BRITISH AMERICAN BLVD LATHAM,NY12110	14-1782466	501(c)(3)	140,000	N/A	N/A	GENERAL SUPPORT
(5) BISHOP CANEVIN CATHOLIC HIGH SCHOOL 2700 MORANGE ROAD PITTSBURGH,PA15205	20-0479485	501(c)(3)	10,000	N/A	N/A	GENERAL SUPPORT
(6) BRIDGE TO THE MOUNTAINS INC 1526 RHINE STREET PITTSBURGH,PA15212	82-1631936	501(c)(3)	20,000	N/A	N/A	GENERAL SUPPORT
(7) CARNEGIE MELLON UNIVERSITY 5000 FORBES AVENUE PITTSBURGH,PA15213	25-0969449	501(c)(3)	50,000	N/A	N/A	GENERAL SUPPORT
(8) CENTER FOR PUBLIC JUSTICE PO BOX 48368 WASHINGTON,DC20002	51-0153566	501(c)(3)	10,000	N/A	N/A	GENERAL SUPPORT
(9) CENTER OF LIFE 161 HAZELWOOD AVE PITTSBURGH,PA15207	01-0617023	501(c)(3)	20,000	N/A	N/A	GENERAL SUPPORT
(10) CENTRAL PENNSYLVANIA FOOD BANK 3908 COREY ROAD HARRISBURG,PA17109	23-2202250	501(c)(3)	10,000	N/A	N/A	GENERAL SUPPORT
(11) COMMUNITY ACTION OF ORLEANS & GENESEE 409 E STATE STREET ALBION,NY14411	16-6059252	501(c)(3)	125,000	N/A	N/A	GENERAL SUPPORT
(12) COMMUNITY COLLEGE OF ALLEGHENY 808 RIDGE AVE 102 Pittsburgh,PA15212	25-1384469	501(c)(3)	500,000	N/A	N/A	GENERAL SUPPORT
(13) COMMUNITY OF HOPE INC 4 ATLANTIC STREET SW WASHINGTON,DC20032	52-1184749	501(c)(3)	15,000	N/A	N/A	GENERAL SUPPORT
(14) COMPREHENSIVE YOUTH DEVELOPMENT INC 240 SECOND AVE NEW YORK,NY10003	13-3861648	501(c)(3)	25,000	N/A	N/A	GENERAL SUPPORT
(15) COUNTY OF CATTARAUGUS 1 Leo Moss Dr Suite 4010 Olean,NY14760	16-6002555	GOV	250,000	N/A	N/A	GENERAL SUPPORT
(16) DONELSON CHRISTIAN ACADEMY INC 300 DANYACREST DRIVE NASHVILLE,TN37214	62-0854263	501(c)(3)	10,000	N/A	N/A	GENERAL SUPPORT
(17) EAST LIBERTY FAMILY HEALTH CARE CENTER 6023 HARVARD STREET PITTSBURGH,PA15206	25-1417228	501(c)(3)	20,000	N/A	N/A	GENERAL SUPPORT
(18) EASTMINISTER PRESBYTERIAN CHURCH 250 N HIGHLAND AVENUE PITTSBURGH,PA15206	25-0979378	501(c)(3)	25,000	N/A	N/A	GENERAL SUPPORT
(19) EDINBORO UNIVERSITY OF PA 210 MEADVILLE STREET EDINBORO,PA16444	25-1575573	501(c)(3)	10,000	N/A	N/A	GENERAL SUPPORT
(20) FLORIDA KEYS CHILDREN'S SHELTER INC 73 HIGH POINT ROAD TAVERNIER,FL33070	59-2605356	501(c)(3)	10,000	N/A	N/A	GENERAL SUPPORT
(21) FREEDOM HOUSE INC 2004 STATE ROUTE 31 SUITE 9 CLINTON,NJ08809	22-2638093	501(c)(3)	10,000	N/A	N/A	GENERAL SUPPORT
(22) GENERATION HOPE 415 MICHIGAN AVENUE NE SUITE 430 WASHINGTON,DC20017	27-3554088	501(c)(3)	20,000	N/A	N/A	GENERAL SUPPORT
(23) HEIRS CHRISTIAN CENTER CHURCH PO BOX 7064 CHARLOTTE,NC28241	27-3855103	501(c)(3)	15,000	N/A	N/A	GENERAL SUPPORT
(24) JDRF INTERNATIONAL 501 MARTINDALE STREET SUITE 670 PITTSBURGH,PA15212	23-1907729	501(c)(3)	55,000	N/A	N/A	GENERAL SUPPORT
(25) MARIO LEMIEUX FOUNDATION TWO CHATHAM CENTER SUITE 1661 PITTSBURGH,PA15219	25-1708231	501(c)(3)	10,000	N/A	N/A	GENERAL SUPPORT
(26) OPEN HAND MINISTRIES INC 616 N HIGHLAND AVENUE OFFICE 108 PITTSBURGH,PA15206	41-2264760	501(c)(3)	10,000	N/A	N/A	GENERAL SUPPORT
(27) PENN STATE HEALTH PO BOX 852 HERSHEY,PA17033	47-3769205	501(c)(3)	20,000	N/A	N/A	GENERAL SUPPORT
(28) PENN STATE UNIVERSITY 116 OLD MAIN COLLEGE OF MEDICINE UNIVERSITY PARK,PA16802	24-6000376	GOV	10,000	N/A	N/A	GENERAL SUPPORT
(29) PITTSBURGH URBAN CHRISTIAN SCHOOL INC 809 CENTER STREET PITTSBURGH,PA15221	25-1405301	501(c)(3)	30,000	N/A	N/A	GENERAL SUPPORT
(30) RUSSELL SAGE COLLEGE 65 First Street Troy,NY12180	14-1338488	501(c)(3)	125,000	N/A	N/A	GENERAL SUPPORT
(31) SECOND HARVEST FOOD BANK OF MIDDLE TENNESSEE INC 331 GREAT CIRCLE ROAD NASHVILLE,TN37228	62-1049447	501(c)(3)	10,000	N/A	N/A	GENERAL SUPPORT
(32) SECOND PRESBYTERIAN CHURCH 3511 BELMONT BLVD NASHVILLE,TN37215	62-0644692	501(c)(3)	10,000	N/A	N/A	GENERAL SUPPORT
(33) STVINCENT DE PAUL SOCIETY NAPLES DISTRICT COUNCIL INC 4451 MERCANTILE AVENUE NAPLES,PA34104	59-1711287	501(c)(3)	10,000	N/A	N/A	GENERAL SUPPORT
(34) TALK THE NEW SEX ED INC 2359 RAILROAD STREET APT 2616 PITTSBURGH,PA15222	27-1563469	501(c)(3)	10,000	N/A	N/A	GENERAL SUPPORT
(35) THE ADVANCED LEADERSHIP INSTITUTE INC 500 GRANT STREET SUITE 4125 PITTSBURGH,PA15219	85-3695252	501(c)(3)	10,000	N/A	N/A	GENERAL SUPPORT
(36) THE ALLEGHENY CENTER CHRISTIAN & MISSIONARY ALLIANCE CHURCH 250 EAST OHIO STREET PITTSBURGH,PA15212	25-1048750	501(c)(3)	10,000	N/A	N/A	GENERAL SUPPORT
(37) THE CATHOLIC UNIVERSITY OF AMERICA 620 MICHIGAN AVENUE NE WASHINGTON,PA20064	53-0196583	501(c)(3)	50,000	N/A	N/A	GENERAL SUPPORT
(38) THE FOUNDATION FOR ENHANCING COMMUNITIES 200 NORTH 3RD STREET 8TH FLOOR HARRISBURG,PA17101	01-0564355	501(c)(3)	15,000	N/A	N/A	GENERAL SUPPORT
(39) THE PITTSBURGH FOUNDATION 5 PPG PLACE SUITE 250 PITTSBURGH,PA15222	25-0965466	501(c)(3)	270,000	N/A	N/A	GENERAL SUPPORT
(40) THE PITTSBURGH PROMISE 1901 CENTRE AVENUE SUITE 204 PITTSBURGH,PA15219	26-1982661	501(c)(3)	10,000	N/A	N/A	GENERAL SUPPORT
(41) TICKETS FOR KIDS FOUNDATION 700 BLAW AVENUE SUITE 105 PITTSBURGH,PA15238	02-0559825	501(c)(3)	10,000	N/A	N/A	GENERAL SUPPORT
(42) TREE OF LIFE CONGREGATION 5898 WILKINS AVENUE PITTSBURGH,PA15217	25-0979381	501(c)(3)	50,000	N/A	N/A	GENERAL SUPPORT
(43) UNITED WAY FOUNDATION OF THE CAPITAL REGION 2235 MILLENNIUM WAY ENOLA,PA17025	25-1733405	501(c)(3)	10,000	N/A	N/A	GENERAL SUPPORT
(44) UNIVERSITY OF PITTSBURGH 128 N CRAIG STREET PITTSBURGH,PA15213	25-0965591	501(c)(3)	10,000	N/A	N/A	GENERAL SUPPORT
(45) VILLANOVA UNIVERSITY 800 LANCASTER AVENUE VILLANOVA,PA19085	23-1352688	501(c)(3)	100,000	N/A	N/A	GENERAL SUPPORT
(46) WASHINGTON CITY MISSION 84 WEST WHEELING STREET WASHINGTON,PA15301	25-1051749	501(c)(3)	10,000	N/A	N/A	GENERAL SUPPORT
(47) WILL ALLEN FOUNDATION 5800 AYLESBORO AVENUE PITTSBURGH,PA15217	47-2025476	501(c)(3)	40,000	N/A	N/A	GENERAL SUPPORT
(48) WILL GEER'S THEATRICUM BOTANICUM 1419 N TOPANGA CANYON BLVD TOPANGA,CA90290	23-7369475	501(c)(3)	10,000	N/A	N/A	GENERAL SUPPORT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) Rev. 1-2025

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference

Explanation

Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds

HIGHMARK HEALTH AWARDS GRANTS TO ORGANIZATIONS DEMONSTRATING A CHARITABLE PURPOSE AND COMMUNITY BENEFIT ALIGNED WITH OUR MISSION. REQUESTS ARE TRACKED VIA OUR GIVING PLATFORM, REVIEWED BY THE CORPORATE GIVING TEAM, AND APPROVED BY EXECUTIVE LEADERSHIP. THE CORPORATE GIVING TEAM CONTINUOUSLY MONITORS THE USAGE OF FUNDS FOR ADHERENCE TO OUR CHARITABLE MISSION. AS PART OF THIS MONITORING, GRANTEES MAY BE REQUIRED TO SUBMIT PERIODIC REPORTS ON THEIR USE OF GRANT FUNDS. CORRECTIVE ACTION PLANS ARE IMPLEMENTED IF NEEDED.

Schedule I (Form 990) Rev. 1-2025

Additional Data

Software ID:	24020961
Software Version:	2024v5.1

- TIN:

SCHEDULE O
(Form 990)
(Rev. January 2025)
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.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

Open to Public
Inspection

Name of the organization

Highmark Health

Employer identification number

45-3674900

Return Reference	Explanation
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons	JOSEPH GUYAUX, DAVID BLANDINO, M.D., STEVEN HOFFMAN, NACD.DC, GREGORY JORDAN, ESQ., DAVID MALONE, AND DAVID HOLMBERG - Business relationship
Form 990, Part VI, Line 4 Significant changes to organizational documents	HIGHMARK HEALTH'S BYLAWS WERE AMENDED IN FEBRUARY 2024. THESE AMENDMENTS INCLUDED UPDATING THE LIST OF SUPPORTED ORGANIZATIONS BY ADDING GROVE CITY MEDICAL CENTER AND SAINT VINCENT HEALTH CENTER, AND REMOVING SAINT VINCENT HEALTH SYSTEM. IN ADDITION, THE CRITERIA FOR BOARD MEMBERSHIP WERE REVISED. SPECIFICALLY, THE REQUIREMENT THAT CERTAIN DIRECTORS BE COMMON TO OTHER AFFILIATED ORGANIZATIONS WAS REMOVED.
Form 990, Part VI, Line 11b Review of form 990 by governing body	THE HIGHMARK HEALTH IRS FORM 990 WAS REVIEWED BY SENIOR MANAGEMENT, THE AUDIT AND COMPLIANCE COMMITTEE, AND EXTERNAL TAX ADVISORS, AND THEN PROVIDED TO THE BOARD OF DIRECTORS FOR THEIR REVIEW PRIOR TO FILING.
Form 990, Part VI, Line 12c Conflict of interest policy	HIGHMARK HEALTH HAS AN INTEGRATED RISK OPERATIONS 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 INTEGRATED RISK OPERATIONS 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 INTEGRATED RISK OPERATIONS DEPARTMENT. INDIVIDUALS ARE REQUIRED TO REPORT TO THE INTEGRATED RISK OPERATIONS 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 INTEGRATED RISK OPERATIONS DEPARTMENT REVIEWS ALL DISCLOSURES. THOSE DISCLOSURE STATEMENTS THAT REQUIRE ADDITIONAL INFORMATION OR CLARIFICATION ARE CONTACTED BY THE INTEGRATED RISK OPERATIONS DEPARTMENT REQUESTING SUCH. - ONCE RECEIVED, THE INTEGRATED RISK OPERATIONS 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 HIGHMARK HEALTH AS WELL AS THE BOARD OF DIRECTORS OF HIGHMARK HEALTH.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	HIGHMARK HEALTH CORPORATE FOLLOWS A PROCESS FOR DETERMINING COMPENSATION FOR EXECUTIVE POSITIONS (INCLUDING OFFICERS, KEY EMPLOYEES AND OTHER MANAGEMENT POSITIONS) AND ARE COVERED BY THE HIGHMARK HEALTH EXECUTIVE COMPENSATION POLICY. THE POLICY WAS APPROVED BY THE HIGHMARK HEALTH BOARD OF DIRECTORS. IT IS THE POLICY OF HIGHMARK HEALTH 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 HIGHMARK HEALTH. THE COMPENSATION AND HUMAN RESOURCES COMMITTEE (C&HR) RECOMMENDS AND THE HIGHMARK HEALTH BOARD APPROVES THE COMPENSATION FOR THE PRESIDENT AND CEO OF HIGHMARK HEALTH. THE C&HR COMMITTEE APPROVES THE COMPENSATION OF ALL SENIOR EXECUTIVES WHO REPORT DIRECTLY TO THE PRESIDENT AND CEO OF HIGHMARK HEALTH, THE COMPENSATION OF THE PRESIDENT AND CEO OF AHN AND ALL EXECUTIVE OFFICERS OF THE ENTERPRISE WHO HAVE A BUSINESS TITLE OF EXECUTIVE VICE PRESIDENT. THE C&HR 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 HIGHMARK HEALTH CEO, AHN CEO AND THE EXECUTIVE DIRECT REPORTS OF EACH. EACH C&HR COMMITTEE MEMBER APPROVING 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. HIGHMARK HEALTH MANAGEMENT, IN COORDINATION WITH THE INDEPENDENT CONSULTANT TO THE HIGHMARK HEALTH C&HR 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 AND NON-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. HIGHMARK HEALTH FOLLOWS THE REQUIREMENT IN THE REGULATIONS TO COMPLY WITH THE REBUTTABLE PRESUMPTION OF THE REASONABLENESS OF COMPENSATION.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	HIGHMARK HEALTH CORPORATE FOLLOWS A PROCESS FOR DETERMINING COMPENSATION FOR EXECUTIVE POSITIONS (INCLUDING OFFICERS, KEY EMPLOYEES AND OTHER MANAGEMENT POSITIONS) AND ARE COVERED BY THE HIGHMARK HEALTH EXECUTIVE COMPENSATION POLICY. THE POLICY WAS APPROVED BY THE HIGHMARK HEALTH BOARD OF DIRECTORS. IT IS THE POLICY OF HIGHMARK HEALTH 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 HIGHMARK HEALTH. THE COMPENSATION AND HUMAN RESOURCES COMMITTEE (C&HR) RECOMMENDS AND THE HIGHMARK HEALTH BOARD APPROVES THE COMPENSATION FOR THE PRESIDENT AND CEO OF HIGHMARK HEALTH. THE C&HR COMMITTEE APPROVES THE COMPENSATION OF ALL SENIOR EXECUTIVES WHO REPORT DIRECTLY TO THE PRESIDENT AND CEO OF HIGHMARK HEALTH, THE COMPENSATION OF THE PRESIDENT AND CEO OF AHN AND ALL EXECUTIVE OFFICERS OF THE ENTERPRISE WHO HAVE A BUSINESS TITLE OF EXECUTIVE VICE PRESIDENT. THE C&HR 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 HIGHMARK HEALTH CEO, AHN CEO AND THE EXECUTIVE DIRECT REPORTS OF EACH. EACH C&HR COMMITTEE MEMBER APPROVING 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. HIGHMARK HEALTH MANAGEMENT, IN COORDINATION WITH THE INDEPENDENT CONSULTANT TO THE HIGHMARK HEALTH C&HR 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 AND NON-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. HIGHMARK HEALTH FOLLOWS THE REQUIREMENT IN THE REGULATIONS TO COMPLY WITH THE REBUTTABLE PRESUMPTION OF THE REASONABLENESS OF COMPENSATION.
Form 990, Part VI, Line 19 Required documents available to the public	HIGHMARK HEALTH DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY PUBLICLY AVAILABLE. HIGHMARK HEALTH'S AUDITED FINANCIAL STATEMENTS ARE INCLUDED IN A CONSOLIDATED HEALTH SYSTEM STATEMENT AND ARE AVAILABLE UPON REQUEST AND WITH CFO APPROVAL.
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	EQUITY TRANSFERS FROM SUBSIDIARIES & OTHER - 36086624; Total - 36086624;
Form 990, Part IX, Statement of Functional Expenses	PURSUANT TO TREASURY REGULATION SECTION 1.6033-2(D)(5), HIGHMARK HEALTH HAS ELECTED TO REPORT COMPENSATION AND SCHEDULE J OTHER INFORMATION ABOUT OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES AND CERTAIN HIGHLY PAID EMPLOYEES ON A CONSOLIDATED BASIS FOR ALL MEMBERS OF THE HIGHMARK HEALTH GROUP, INCLUDING THIS PARENT ORGANIZATION THAT IS THE CENTRAL ORGANIZATION OF THE GROUP, ON THE RETURN OF THE HIGHMARK GROUP RETURN. HIGHMARK HEALTH CONTINUES TO REPORT ITS SHARE OF FUNCTIONAL EXPENSES ON A STANDALONE BASIS ON PART IX.
Form 990, Part VII, Section A and B	THIS STATEMENT SERVES AS A REQUEST FOR CONSENT PURSUANT TO REGULATION SECTION 1.6033-2(D)(5). DUE TO THE LACK OF AN ESTABLISHED PROCESS, THE TAXPAYER IS NOTIFYING THE COMMISSIONER IN THIS MANNER. PART VII, SECTION A AND B COMPENSATION OF OFFICERS, TRUSTEES, KEY EMPLOYEES, AND HIGHEST PAID EMPLOYEES SECTION A: PURSUANT TO TREASURY REGULATION SECTION 1.6033-2(D)(5), HIGHMARK HEALTH HAS ELECTED TO REPORT COMPENSATION AND SCHEDULE J OTHER INFORMATION ABOUT OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES AND CERTAIN OTHER HIGHLY PAID EMPLOYEES ON A CONSOLIDATED BASIS FOR ALL OF THE MEMBERS OF THE HIGHMARK HEALTH GROUP, INCLUDING THIS PARENT ORGANIZATION THAT IS THE SPONSOR OF CENTRAL ORGANIZATION OF THE GROUP, ON THE RETURN OF HIGHMARK HEALTH GROUP (EIN: 82-1406555). SECTION B: PURSUANT TO TREASURY REGULATIONS SECTION 1.6033-2(D)(5), HIGHMARK HEALTH HAS ELECTED TO REPORT CERTAIN PROFESSIONAL CONTRACTORS AND CERTAIN OTHER CONTRACTORS ON A CONSOLIDATED BASIS FOR ALL OF THE MEMBERS OF THE HIGHMARK HEALTH GROUP, INCLUDING THIS PARENT ORGANIZATION THAT IS THE SPONSOR ORGANIZATION OF THE GROUP, ON THE RETURN OF HIGHMARK HEALTH GROUP (EIN: 82-1406555).
Form 990, PART VIII STATEMENT OF REVENUE	LINE 1 CONTRIBUTIONS AND GRANTS: PURSUANT TO TREASURY REGULATION SECTION 1.6033-2(D)(5), HIGHMARK HEALTH HAS ELECTED TO REPORT INFORMATION RELATED TO ITS CONTRIBUTIONS AND GRANTS RECEIVED ON A CONSOLIDATED BASIS FOR ALL THE MEMBERS OF THE HIGHMARK HEALTH GROUP, INCLUDING THIS PARENT ORGANIZATION THAT IS THE SPONSOR ORGANIZATION OF THE GROUP, ON THE RETURN OF HIGHMARK HEALTH GROUP (EIN: 82-1406555).

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) (Rev. 1-2025)

Additional Data

Software ID:	24020961
Software Version:	2024v5.1

- TIN:

SCHEDULE R
(Form 990)
(Rev. January 2025)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

Open to Public Inspection

Name of the organization

Highmark Health

Employer identification number

45-3674900

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
(1) ENDORSED LLC 120 5th Avenue Tax Pittsburgh,PA15222 87-1511522	HEALTHCARE	PA	2,177,185	11,907,679	Highmark Health

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?
(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	Yes	No
(1)CANONSBURG HOSPITAL & HEALTH FOUNDATION 100 MEDICAL BOULEVARD CANONSBURG,PA15317 25-1818505	INACTIVE	PA	501(c)(3)	Type I	NA		No
(2)EMERGYCARE INC 232 WEST 25TH STREET ERIE,PA16544 25-1430922	HEALTHCARE	PA	501(c)(3)	10	SVHC		No
(3)GREATER CANONSBURG HEALTH SYSTEM 100 MEDICAL BOULEVARD CANONSBURG,PA15317 25-1488089	INACTIVE	PA	501(c)(3)	Type I	NA		No
(4)REGIONAL CANCER CENTER 232 WEST 25TH STREET ERIE,PA16544 25-1385705	INACTIVE	PA	501(c)(3)	3	SVHS		No
(5)REGIONAL HEART NETWORK 232 WEST 25TH STREET ERIE,PA16544 25-1856341	HEALTHCARE	PA	501(c)(3)	3	SVHC		No
(6)VANTAGE HEALTH GROUP 232 WEST 25TH STREET ERIE,PA16544 25-1498145	HEALTHCARE	PA	501(c)(3)	3	SVHC		No
(7)WEST ALLEGHENY HOSPITAL 100 MEDICAL BOULEVARD PITTSBURGH,PA15317 25-1054206	INACTIVE	PA	501(c)(3)	3	NA		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) (Rev. 1-2025)

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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) 5148 LIBERTY AVENUE ASSOCIATES 5989 CENTRE AVENUE PITTSBURGH,PA15206 25-1689871	PROPERTY RENTAL	PA	NA	N/A
(2) AHN EMERGENCY MEDICINE MGMT 30 ISABELLA ST PITTSBURGH,PA15212 46-5705484	MEDICAL PRACTICE	PA	NA	N/A
(3) AHN EMERUS LLC 30 ISABELLA ST PITTSBURGH,PA15212 82-3655381	MEDICAL PRACTICE	PA	NA	N/A
(4) AHN- LECOM JV LLC 30 ISABELLA ST PITTSBURGH,PA15212 82-5500526	HEALTHCARE	PA	NA	N/A
(5) CELTIC HOSPICE LLC 30 ISABELLA ST PITTSBURGH,PA15212 20-5661063	MEDICAL PRACTICE	PA	NA	N/A
(6) EQUINOX SOLUTION DESIGN CENTER LLC 87-1820806	IT SOLUTIONS	PA	Highmark Health	Related	0	0		No		Yes		50 %
(7) EQUINOX OPERATIONS LLC 88-3245305	IT SOLUTIONS	PA	Highmark Health	Related	0	306,014		No		Yes		50 %
(8) GATEWAY HEALTH PLAN LP 25-1691945	HEALTH PLAN	PA	NA	N/A
(9) JENKINS EMPIRE ASSOCIATES 25-1524682	PROPERTY MANAGEMENT	PA	NA	N/A
(10) JV HOLDCO LLC 30 ISABELLA ST PITTSBURGH,PA15212 47-2368587	HOLDING COMPANY	PA	NA	N/A
(11) MCCANDLESS ENDOSCOPY CENTER 4800 FRIENDSHIP AVE PITTSBURGH,PA15224 26-1284448	MEDICAL PRACTICE	PA	NA	N/A
(12) PROVIDER PPI LLC 32-0429947	GROUP PURCHASING	PA	NA	N/A
(13) SAINT VINCENT PROFESSIONAL BLD 312 WEST 25TH STREET ERIE,PA16502 25-1578290	PROPERTY MGMT	PA	NA	N/A
(14) SILVER RAIN LP 30 ISABELLA ST PITTSBURGH,PA15212 27-3035436	PROPERTY MGMT	PA	NA	N/A
(15) THRYVE DIGITAL HEALTH LLP 98-1311003	INFO TECH		NA	N/A
(16) VANTAGE HOLDING COMPANY LLC 312 WEST 25TH STREET ERIE,PA16502 03-0477182	CAPITAL MGMT	PA	NA	N/A
(17) JEFFERSON MEDICAL ASSOCIATES LP 600 Rugh Street Greensburg,PA15601 25-1740456	Real Estate	PA	NA	N/A
(18) SAINT VINCENT NWPA SURGERY CENTER LTD 120 FIFTH AVENUE SUITE 2922 PITTSBURGH,PA15222 05-0591755	INACTIVE	PA	NA	N/A
(19) INTER-COUNTY HOSPITALIZATION PLAN INC 120 FIFTH AVENUE SUITE 2922 PITTSBURGH,PA15222 23-0724427	INACTIVE	PA	NA	N/A
(20) INTER-COUNTY HEALTH PLAN INC 120 FIFTH AVENUE SUITE 2922 PITTSBURGH,PA15222 23-2063810	INACTIVE	PA	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?
(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	Yes	No
(1) BROKERAGE CONCEPTS LLC 257 WEST GENESEE STREET BUFFALO,NY142022657 11-3667763	Insurance	DE	HM Health	C Corporation	20,359,070	118,729,905	100 %	Yes
(2) CHAUTAUQUA MEDICAL PRACTICE PC 4936 MAIN STREET PO Box 470 BENMUS POINT,NY14712 27-1939478	Medical Practice	NY	NA	C Corporation					No
(3) CLINICAL SERVICES INC 232 WEST 25TH STREET ERIE,PA16544 25-1403846	Holding Company	PA	AHN	C Corporation	6,625,703	67,754,200	100 %	Yes
(4) FIRST PRIORITY LIFE INSURANCE COMPANY 19 NORTH MAIN STREET WILKLESBARRE,PA18711 23-2905083	Insurance	PA	NA	C Corporation					No
(5) GATEWAY HEALTH PLAN OF OHIO INC 444 LIBERTY AVENUE SUITE 2100 PITTSBURGH,PA15222 30-0282076	Insurance	OH	NA	C Corporation					No
(6) GATEWAY HEALTH PLAN INC 444 LIBERTY AVENUE SUITE 2100 PITTSBURGH,PA15222 25-1505506	Insurance	PA	NA	C Corporation					No
(7) HCI INC 120 FIFTH AVE TAX PITTSBURGH,PA15222 75-3002215	Insurance	VT	NA	C Corporation					No
(8) HEALTH SYSTEM SERVICES CORP 565 COAL VALLEY RD JEFFERSON HILLS,PA15025 25-1403745	Medic. Office Blg	PA	CSI	C Corporation	2,936,298	21,945,069	100 %	Yes
(9) HIGHMARK BCBSD HEALTH OPTIONS INC 800 DELAWARE AVENUE WILMINGTON,DE198011368 47-1817274	Insurance	DE	NA	C Corporation					No
(10) HIGHMARK BCBSD INC 800 DELAWARE AVENUE WILMINGTON,DE198011368 51-0020405	Insurance	DE	NA	C Corporation					No
(11) HIGHMARK BENEFITS GROUP INC 120 FIFTH AVE TAX PITTSBURGH,PA15222 46-4763378	Insurance	PA	NA	C Corporation					No
(12) BRIDGE CITY INSURANCE COMPANY (PREVISOULY HIGHMARK CASUALTY INSURANCE COMPA NY) 120 FIFTH AVE TAX PITTSBURGH,PA15222 25-1334623	Insurance	PA	NA	C Corporation					No
(13) HIGHMARK ASSURE HEALTH INC 120 FIFTHE AVE TAX PITTSBURGH,PA15222 99-4255093	insurance	PA	NA	C Corporation					No
(14) HIGHMARK CARE BENEFITS INC 120 FIFTHE AVE TAX PITTSBURGH,PA15222 99-4254510	insurance	PA	NA	C Corporation					No
(15) HIGHMARK COVERAGE ADVANTAGE INC 120 FIFTH AVE TAX PITTSBURGH,PA15222 46-4757476	Insurance	PA	NA	C Corporation					No
(16) HIGHMARK INC 120 FIFTH AVE TAX PITTSBURGH,PA15222 23-1294723	Insurance	PA	HM Health	C Corporation	32,331,234,473	12,795,461,759	100 %		No
(17) HIGHMARK SENIOR HEALTH COMPANY 120 FIFTH AVE TAX PITTSBURGH,PA15222 46-4156633	Insurance	PA	NA	C Corporation					No
(18) HIGHMARK SENIOR SOLUTIONS COMPANY 120 FIFTH AVE TAX PITTSBURGH,PA15222 46-4156854	Insurance	WV	NA	C Corporation					No
(19) HIGHMARK WEST VIRGINIA PO BOX 1948 PARKERSBURG,WV26102 55-0624615	Insurance	WV	NA	C Corporation					No
(20) HIGHMARK WESTERN AND NORTHEASTERN NEW YORK INC 257 WEST GENESEE STREET BUFFALO,NY14202 16-1105741	Insurance	NY	NA	C Corporation					No
(21) HIGHMARK WESTERN AND NORTHEASTERN NEW YORK HOLDINGS 257 WEST GENESEE STREET BUFFALO,NY14202 11-3667761	Holding Company	NY	NA	C Corporation					No
(22) HIGHMARK VENTURES LLC 120 FIFTHE AVE TAX PITTSBURGH,PA15222 25-1645888	insurance	PA	NA	C Corporation					No
(23) HM CENTERED HEALTH INC 120 FIFTH AVE TAX PITTSBURGH,PA15222 20-5457337	Insurance	PA	NA	C Corporation					No
(24) HM HEALTH HOLDINGS COMPANY 120 FIFTH AVE TAX PITTSBURGH,PA15222 81-0919390	Holding Company	PA	HM Health	C Corporation	2,121,215	23,697,588	100 %	Yes
(25) HM HEALTH INSURANCE COMPANY 120 FIFTH AVE TAX PITTSBURGH,PA15222 54-1637426	Insurance	PA	NA	C Corporation					No
(26) HM HEALTH SOLUTIONS INC 120 FIFTH AVE TAX PITTSBURGH,PA15222 46-3823617	Info Technology	PA	HM Health	C Corporation	1,144,761,915	327,952,378	100 %	Yes
(27) HM INSURANCE GROUP 120 FIFTH AVE TAX PITTSBURGH,PA15222 25-1646315	Holding Company	PA	NA	C Corporation					No
(28) HM LIFE INSURANCE COMPANY 19 NORTH MAIN STREET WILKESBARRE,PA18711 06-1041332	Insurance	PA	NA	C Corporation					No
(29) HM LIFE INSURANCE COMPANY OF NEW YORK 120 FIFTH AVE TAX PITTSBURGH,PA15222 25-1800302	Insurance	NY	NA	C Corporation					No
(30) HMO OF NORTHEASTERN PENNSYLVANIA INC 120 FIFTH AVE TAX PITTSBURGH,PA15222 23-2413324	Insurance	PA	NA	C Corporation					No
(31) HMPG INC 120 FIFTH AVE TAX PITTSBURGH,PA15222 45-3444325	Holding Company	PA	CSI	C Corporation	3,508,484	187,020,770	100 %	Yes
(32) JEA INC 120 FIFTH AVE TAX PITTSBURGH,PA15222 25-1712017	Real Estate Ops	PA	NA	C Corporation					No
(33) HIGHMARK CHOICE COMPANY 120 FIFTH AVE TAX PITTSBURGH,PA15222 25-1522457	Insurance	PA	NA	C Corporation					No
(34) PALLADIUM RISK RETENTION GROUP 120 FIFTH AVE TAX PITTSBURGH,PA15222 46-3476730	Insurance	VT	WPAHS Inc	C Corporation	36,528,183	138,206,712	100 %	Yes
(35) PHYSICIAN LANDING ZONE PC 120 FIFTH AVE TAX PITTSBURGH,PA15222 45-3913973	Health Care	PA	AC	C Corporation	735	10,244,332	100 %	Yes
(36) PREMIER MEDICAL ASSOCIATES PC 120 FIFTH AVE TAX PITTSBURGH,PA15222 25-1742869	Health Care	PA	NA	C Corporation					No
(37) PREMIER WOMEN'S HEALTH 120 FIFTH AVE TAX PITTSBURGH,PA15222 46-4682160	Medical Practice	PA	AC	C Corporation	0	0	100 %	Yes
(38) UNITED CONCORDIA COMPANIES INC 4401 DEER PATH ROAD HARRISBURG,PA17110 25-1687586	Dental Insurance	PA	NA	C Corporation					No
(39) UNITED CONCORDIA DENTAL PLANS OF CA 4401 DEER PATH ROAD HARRISBURG,PA17110 23-7328765	Dental Insurance	CA	NA	C Corporation					No
(40) UNITED CONCORDIA DENTAL PLANS OF PA 4401 DEER PATH ROAD HARRISBURG,PA17110 23-2541529	Dental Insurance	PA	NA	C Corporation					No
(41) UNITED CONCORDIA DENTAL PLANS OF TX 4401 DEER PATH ROAD HARRISBURG,PA17110 74-2489037	Dental Insurance	TX	NA	C Corporation					No
(42) UNITED CONCORDIA DENTAL PLANS - MIDWEST 4402 DEER PATH ROAD HARRISBURG,PA17110 38-2289438	Dental Insurance	MI	NA	C Corporation					No
(43) UNITED CONCORDIA DENTAL PLANS INC 4403 DEER PATH ROAD HARRISBURG,PA17110 52-1542269	Dental Insurance	MD	NA	C Corporation					No
(44) UNITED CONCORDIA INSURANCE COMPANY 4404 DEER PATH ROAD HARRISBURG,PA17110 86-0307623	Dental Insurance	AZ	NA	C Corporation					No
(45) UNITED CONCORDIA INSURANCE COMPANY OF NY 4405 DEER PATH ROAD HARRISBURG,PA17110 11-3008245	Dental Insurance	NY	NA	C Corporation					No
(46) WEST PENN NEUROSURGERY PC 4800 FRIENDSHIP AVENUE PITTSBURGH,PA15224 25-1630719	Medical Practice	PA	WPAHS Inc	C Corporation	0	0	100 %	Yes
(47) WEST VIRGINIA FAMILY HEALTH PLAN INC (HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC) 1219 VIRGINIA STREET EAST CHARLESTON,WV25301 45-2763165	Insurance	WV	NA	C Corporation					No
(48) WEXFORD MEDICAL MALL AND HOSPITAL CONDO ASSOC 120 Fifth Avenue Tax PITTSBURGH,PA15222 84-2176985	Real Estate Ops	PA	WPAHS Inc	C Corporation	0	857,200	100 %	Yes

Schedule R (Form 990) (Rev. 1-2025)

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

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 .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

Yes

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

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) ALLEGHENY HEALTH NETWORK	L	115,780,734	FMV
(2) ALLEGHENY HEALTH NETWORK	Q	117,666,331	FMV
(3) HIGHMARK INC	C	36,113,760	FMV
(4) HIGHMARK INC	L	874,468,757	FMV
(5) HIGHMARK INC	M	181,723,497	FMV
(6) HIGHMARK INC	P	182,484,544	FMV
(7) HIGHMARK INC	Q	906,646,235	FMV
(8) HM HEALTH HOLDINGS COMPANY	L	1,289,844	FMV
(9) HM HEALTH HOLDINGS COMPANY	M	2,144,621	FMV
(10) HM HEALTH HOLDINGS COMPANY	P	1,923,530	FMV
(11) HM HEALTH HOLDINGS COMPANY	Q	1,240,505	FMV
(12) HM HEALTH SOLUTIONS	L	89,346,418	FMV
(13) HM HEALTH SOLUTIONS	M	117,727,691	FMV
(14) HM HEALTH SOLUTIONS	P	119,352,221	FMV
(15) HM HEALTH SOLUTIONS	Q	88,752,752	FMV

Schedule R (Form 990) (Rev. 1-2025)

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)	(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
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) (Rev. 1-2025)

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) (Rev. 1-2025)

Additional Data

Software ID:	24020961
Software Version:	2024v5.1

1	Briefly describe the organization’s mission or most significant activities: HIGHMARK HEALTH'S MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE AND COMMUNITIES IT SERVES BY MAKING HEALTHCARE MORE ACCESSIBLE, UNDERSTANDABLE AND AFFORDABLE.
2	Check this box
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 2024 (Part V, line 2a) ......	5	3,561
6	Total number of volunteers (estimate if necessary) .............	6	13
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	0	0
9	Program service revenue (Part VIII, line 2g) .........	570,518,872	591,788,094
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-2,266,427	10,647,728
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	0	131,149
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	568,252,445	602,566,971
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	8,710,488	2,817,000
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)	483,085,494	478,547,938
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	121,418,112	106,867,771
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	613,214,094	588,232,709
19	Revenue less expenses. Subtract line 18 from line 12.......	-44,961,649	14,334,262
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	689,168,025	676,663,759
21	Total liabilities (Part X, line 26).............	277,317,592	228,191,548
22	Net assets or fund balances. Subtract line 21 from line 20.....	411,850,433	448,472,211

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 442,387,433 including grants of $ 2,817,000 ) (Revenue $ 591,788,094 )
	HIGHMARK HEALTH IS THE PARENT ORGANIZATION OF A BLENDED HEALTH SYSTEM THAT INCLUDES THE ALLEGHENY HEALTH NETWORK AND HIGHMARK INC. HIGHMARK HEALTH PROVIDES STRATEGIC, OPERATIONAL AND ADMINISTRATIVE LEADERSHIP, STEWARDSHIP AND SUPPORT TO THE ALLEGHENY HEALTH NETWORK TO ENABLE IT TO EXECUTE ON ITS CHARITABLE MISSION. HIGHMARK HEALTH'S VISION IS A WORLD WHERE EVERYONE EMBRACES HEALTH. ITS MISSION IS TO CREATE A REMARKABLE HEALTH EXPERIENCE, FREEING PEOPLE TO BE THEIR BEST. THROUGH ITS STRUCTURE AS A BLENDED HEALTH ORGANIZATION, HIGHMARK HEALTH IS UNIQUELY POSITIONED TO PIONEER NEW MODELS AND TRANSFORM THE HEALTHCARE INDUSTRY TO WORK BETTER NOW AND FOR GENERATIONS TO COME. WE BELIEVE THAT WE HAVE A FUNDAMENTAL RESPONSIBILITY TO BE LEADERS AND STEWARDS IN THE COMMUNITY, WORKING TO IMPROVE THE HEALTH AND WELL-BEING OF THOSE WE SERVE BY GIVING BACK TO, REINVESTING IN, AND STRENGTHENING THE COMMUNITIES WHERE OUR CUSTOMERS AND EMPLOYEES LIVE, WORK AND PLAY. HIGHMARK HEALTH, TOGETHER WITH THE ALLEGHENY HEALTH NETWORK, IS DEDICATED TO IMPROVING THE QUALITY OF CARE AND DRIVING DOWN HEALTHCARE COSTS THROUGH THE LIVING HEALTH MODEL. LIVING HEALTH HIGHMARK HEALTH'S BLENDED HEALTH SYSTEM APPROACH CONNECTS PAYERS, PROVIDERS, TECH INNOVATORS, AND COMMUNITY ORGANIZATIONS TO BUILD A HEALTH ECOSYSTEM THAT WORKS BETTER FOR EVERYONE: LIVING HEALTH. THROUGH LIVING HEALTH, HIGHMARK HEALTH IS DRIVING AN ENTERPRISE STRATEGY BY INTEGRATING HEALTH, COVERAGE AND CARE TO DELIVER A SIMPLER, MORE PERSONALIZED, AND PROACTIVE HEALTH EXPERIENCE FOR INDIVIDUALS AND CLINICIANS. LIVING HEALTH IS INTENDED TO REDUCE ORGANIZATIONAL FRICTION AND EXTRACT VALUABLE INSIGHTS WHICH WILL OPTIMIZE OUTCOMES AT A LOWER COST. THE LIVING HEALTH STRATEGY, VENDOR RELATIONSHIPS AND RELATED PARTY SERVICES ARE CONSISTENT WITH HIGHMARK HEALTH'S STATED CHARITABLE MISSION, WHICH INCLUDES: PROVISION OF ACCESS TO AFFORDABLE CARE, STRATEGIC AND OPERATIONAL/ADMINISTRATIVE LEADERSHIP FOR THE HEALTH SYSTEM AND OPERATIONAL OVERSIGHT TO ENSURE EFFECTIVE AND EFFICIENT OPERATION AND PROVISION OF HIGH-QUALITY CARE. THE LIVING HEALTH DYNAMIC PLATFORM IS BEING DESIGNED AS THE HEALTH "OPERATING SYSTEM" OF THE FUTURE AND WILL CONNECT WHAT INDIVIDUALS AND CLINICIANS NEED ON ONE DIGITAL PLATFORM. LIVING HEALTH'S SUCCESS IN ACHIEVING THE QUADRUPLE AIM (BETTER PATIENT EXPERIENCE, CLINICIAN SATISFACTION, AND HEALTH OUTCOMES, WITH LOWER COSTS) WILL PROVIDE A SUSTAINABLE ECONOMIC MODEL THAT CAN SOLVE INDUSTRY PROBLEMS AT SCALE. THE LIVING HEALTH ACTIVITIES ARE CENTRAL TO THE MISSION OF AHN - TO CREATE A REMARKABLE HEALTH EXPERIENCE, FREEING PEOPLE TO BE THEIR BEST. INTRODUCTION TO AHN ALLEGHENY HEALTH NETWORK (AHN), BASED IN PITTSBURGH, PENNSYLVANIA, IS A TAX-EXEMPT, PATIENT-CENTERED AND PHYSICIAN-LED ACADEMIC HEALTHCARE SYSTEM THAT PROVIDES CHARITABLE CARE AND HIGH-QUALITY, COMPREHENSIVE HEALTHCARE SERVICES TO PATIENTS FROM WESTERN PENNSYLVANIA AND THE ADJACENT REGIONS OF OHIO, WEST VIRGINIA, NEW YORK AND MARYLAND. AHN COMPRISES 14 HOSPITALS AND MORE THAN 200 PRIMARY- AND SPECIALTY- CARE PRACTICES IN MORE THAN 300 HEALTHCARE SITES, INCLUDING SIX HEALTH + WELLNESS PAVILIONS; SURGICAL CENTERS AND OUTPATIENT CLINICS; A RESEARCH INSTITUTE; ABOUT 2,500 EMPLOYED AND AFFILIATED PHYSICIANS; APPROXIMATELY 23,000 TOTAL EMPLOYEES; HUNDREDS OF VOLUNTEERS; A GROUP PURCHASING ORGANIZATION; AND A COMPLETE SPECTRUM OF HOME AND COMMUNITY BASED HEALTHCARE SERVICES. THE NETWORK'S HOSPITALS INCLUDE ONE QUATERNARY ACADEMIC MEDICAL CENTER (AHN ALLEGHENY GENERAL HOSPITAL IN PITTSBURGH), NINE TERTIARY/COMMUNITY HOSPITALS THAT PROVIDE A WIDE ARRAY OF GENERAL AND ADVANCED CLINICAL SERVICES (AHN ALLEGHENY VALLEY HOSPITAL, NATRONA HEIGHTS, PA; AHN CANONSBURG HOSPITAL, CANONSBURG, PA; AHN FORBES HOSPITAL, MONROEVILLE, PA; AHN GROVE CITY HOSPITAL, GROVE CITY, PA; AHN JEFFERSON HOSPITAL, JEFFERSON HILLS, PA; AHN SAINT VINCENT HOSPITAL, ERIE, PA; AHN WEST PENN HOSPITAL, PITTSBURGH, PA; AHN WESTFIELD MEMORIAL HOSPITAL, WESTFIELD, NY; AND AHN WEXFORD HOSPITAL, WEXFORD, PA), AND FOUR NEIGHBORHOOD HOSPITALS (AHN HEMPFIELD, GREENSBURG, PA; AHN MCCANDLESS, PITTSBURGH, PA; AHN HARMAR, PITTSBURGH, PA; AND AHN BRENTWOOD, PITTSBURGH, PA). AHN WAS ESTABLISHED IN 2013, BUT ITS MEMBER HOSPITALS SHARE LEGACIES OF CHARITABLE CARE THAT DATE BACK MORE THAN 175 YEARS (WEST PENN HOSPITAL WAS CHARTERED IN 1848). AHN IS AN INTEGRATED DELIVERY SYSTEM SERVING AS THE PARENT ORGANIZATION OF A HEALTHCARE SYSTEM IN WESTERN PENNSYLVANIA. AHN IS THE SOLE MEMBER OF WEST PENN ALLEGHENY HEALTH SYSTEM, CANONSBURG GENERAL HOSPITAL, ALLE-KISKI MEDICAL CENTER, JEFFERSON REGIONAL MEDICAL CENTER, SAINT VINCENT HEALTH CENTER, AND GROVE CITY MEDICAL CENTER. HIGHMARK HEALTH SERVES AS THE ULTIMATE PARENT OF THE AHN AFFILIATES THROUGH ITS POSITION AS THE SOLE MEMBER OF AHN. AHN'S PLAN IS TO TRANSFORM THE CURRENT MODEL OF HEALTHCARE DELIVERY IN WESTERN PENNSYLVANIA BY ENCOURAGING HEALTHCARE PROVIDERS TO USE THE MOST APPROPRIATE, COST-EFFECTIVE VENUE FOR CARE; ADHERE TO THE HIGHEST, EVIDENCE-BASED STANDARDS OF CARE; AND DELIVER SUPERIOR OUTCOMES BY REDUCING UNNECESSARY READMISSIONS AND HEALTHCARE-ASSOCIATED COMPLICATIONS. PROVIDING COST-EFFICIENT, CONVENIENTLY ACCESSED CARE DELIVERS VALUE AND BENEFIT TO LOCAL COMMUNITIES, PARTNER HEALTH CARRIERS, AREA BUSINESSES, AND MOST OF ALL TO AHN'S PATIENTS. OUR "LIVING HEALTH" MODEL OF CARE IS A BLENDED APPROACH THAT CONNECTS PAYERS, PROVIDERS, TECH INNOVATORS, AND COMMUNITY ORGANIZATIONS TO BUILD A HEALTH ECOSYSTEM THAT WORKS BETTER FOR EVERYONE. IN PARTNERSHIP WITH PARENT COMPANY HIGHMARK HEALTH, THE LIVING HEALTH MODEL IS DESIGNED TO CREATE BETTER HEALTHCARE SOLUTIONS, PROGRAMS AND PRODUCTS THAT PROVIDE 360 SUPPORT FOR PHYSICAL, MENTAL, AND SOCIAL HEALTH. TOGETHER WE ARE FOCUSED ON REDESIGNING CARE DELIVERY THROUGH PURPOSEFUL, MEANINGUFL PAYER-PROVIDER PARTNERSHIPS, JOINT VENTURES AND VALUE-BASED COLLABORATIONS IN EACH OF OUR MARKETS. THE GOAL OF AHN IS TO PROMOTE HEALTH AND WELLNESS IN ITS COMMUNITIES BY PROVIDING HIGH-QUALITY, SAFE, COMPASSIONATE, AFFORDABLE HEALTHCARE TO ALL WHO SEEK IT.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses442,387,433

(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/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(1) See Schedule O...................................................................... N/A	0.0 ................. 0	X	X	0	0	0

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	0	0	0

(A) Name and business address	(B) Description of services	(C) Compensation





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 0

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		0

		Business Code
2a	AFFILIATE EXPENSE REIMBURSEMENT	900099	591,788,094	591,788,094
b
c
d
e
f	All other program service revenue.		0	0	0	0
g	Total. Add lines 2a–2f .....		591,788,094

3 Investment income (including dividends, interest, and othersimilar amounts) ......			2,756,025			2,756,025
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........			131,149			131,149
			(i) Real	(ii) Personal
6a	Gross rents	6a
b	Less: rental expenses	6b
c	Rental income or (loss)	6c	0	0
d	Net rental income or (loss).......
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a	8,176,592
b	Less: cost or other basis and sales expenses	7b	126,313	158,576
c	Gain or (loss)	7c	8,050,279	-158,576
d	Net gain or (loss).........			7,891,703			7,891,703
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..

Business Code
11a
b
c
d	All other revenue ....			0	0	0	0
e	Total. Add lines 11a–11d ......			0
12	Total revenue. See instructions.....			602,566,971	591,788,094	0	10,778,877

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	2,817,000	2,817,000
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......	0	0
5	Compensation of current officers, directors, trustees, and key employees ...........	29,465,342	22,087,889	7,377,453
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	1,112,648	834,066	278,582
7	Other salaries and wages........	367,968,509	275,837,541	92,130,968
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	17,956,282	13,460,436	4,495,846
9	Other employee benefits .......	38,796,889	29,083,028	9,713,861
10	Payroll taxes ...........	23,248,268	17,427,429	5,820,839
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	223,528	214,587	8,941
c	Accounting ...........	240,748	231,118	9,630
d	Lobbying ...........	668,291	668,291
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	126,531		126,531
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	2,658,980	2,552,621	106,359	0
12	Advertising and promotion ....
13	Office expenses .......	365,361	273,883	91,478
14	Information technology ......	5,194,013	3,893,550	1,300,463
15	Royalties ..
16	Occupancy ...........	541,858	406,189	135,669
17	Travel ............	7,262,352	5,444,024	1,818,328
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	4,188,927	3,140,115	1,048,812
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	69,456,685	52,066,307	17,390,378
23	Insurance ...	1,151,654	863,306	288,348
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	NON-INCOME TAXES	4,592,785	3,442,856	1,149,929
b	MEMBERSHIP & DUES	2,986,534	2,238,774	747,760
c	HEALTHCARE DELIVERY SERVICES	2,800,841	2,099,574	701,267
d	ADMINISTRATIVE SUPPORT	1,344,699	1,008,017	336,682
e	All other expenses	3,063,984	2,296,832	767,152	0
25	Total functional expenses. Add lines 1 through 24e	588,232,709	442,387,433	145,845,276	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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........				1
2	Savings and temporary cash investments .........			67,755,500	2	101,159,447
3	Pledges and grants receivable, net ......			0	3
4	Accounts receivable, net .............			131,865	4	799,438
5	Loans and other receivables from 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 .......
					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) ...
					6	0
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............				8
9	Prepaid expenses and deferred charges ......			32,383,687	9	31,993,919
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	447,597,315
b	Less: accumulated depreciation	10b	268,617,505	220,040,303	10c	178,979,810
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			0	12
13	Investments—program-related. See Part IV, line 11 ..			0	13
14	Intangible assets ...............				14	7,500,000
15	Other assets. See Part IV, line 11 ...........			368,856,670	15	356,231,145
16	Total assets. Add lines 1 through 15 (must equal line 33)...			689,168,025	16	676,663,759

17	Accounts payable and accrued expenses .....	263,210,133	17	211,641,579
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
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 .........
			22	0
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
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	14,107,459	25	16,549,969
26	Total liabilities. Add lines 17 through 25..	277,317,592	26	228,191,548

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	411,850,433	27	448,472,211
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	411,850,433	32	448,472,211
33	Total liabilities and net assets/fund balances ........	689,168,025	33	676,663,759