Inova Health Plan LLC

“The organization has a single member. The sole member is Inova Health Care Services, a charitable 501(c)(3) tax-exempt organization which is part of the Inova Health System.”

“The sole member of the organization, Inova Health Care Services, is a charitable 501(c)(3) tax-exempt organization. The sole member elects the members of the governing body of the organization.”

“The Form 990 is prepared and provided to the Chief Accounting Officer and external tax consultants for initial review. After the review it is given to the CFO of Inova Health System for his review and comment. The Form 990 is presented to the Executive Committee of the Board of Trustees for their review. Upon completion of the Executive Committee review, it is provided to the full Board of Trustees. In this process, the Form 990 has been provided to the Governing Board approximately two weeks prior to the filing of the return.”

“Yes, annually the organization distributes the conflict of interest policy to all directors, officers, trustees, and key employees. The organization requires that each director, officer, trustee, and key employee acknowledge that they have read, understood, and will abide by the policy. Each director, officer, trustee, and key employee is required to complete and submit an annual conflict of interest disclosure. These disclosures are broad and require that the individual list any business relationships or personal relationships with other directors, officers, trustees, and key employees, as well as any relationships with competitors, or current or potential vendors or contractors. Disclosure statements are reviewed by senior management and any potential conflicts are discussed with governing body chairman to ensure that any member who may have a conflict discloses their potential conflict, and is dismissed from related discussions and recused from participation in applicable decisions.”

“Completed by related entity, Imanco, Inc.: The compensation of all senior management positions is evaluated annually in light of each manager's job content, scope and complexity. Compensation levels for Vice Presidents and above are reviewed by an independent external consultant to ensure that remuneration is consistent with the organization's compensation philosophy and objectives and competitive with other large complex health systems. The independent compensation consultant maintains national benchmark compensation databases and surveys and also reviews Forms 990 of comparable healthcare systems to determine market levels of compensation. In addition, the Inova Health System's CEO's compensation and certain other senior executives is reviewed and approved annually by an independent governing Board. The job requirements and complexity of all other management positions are evaluated annually using nationally recognized third party salary surveys to assure that the compensation for such positions is consistent with external market compensation comparisons. Salary ranges are developed for each management position classification to ensure that the compensation levels for these positions are consistent with the organization's compensation philosophy and objectives and with competitive market comparisons.”

“Inova Health System makes certain information publicly available. Inova's consolidated financial statements are posted on the Electronic Municipal Market Access's (EMMA) website on a quarterly basis. Inova's governing documents are not currently publicly available. While the conflict of interest policy is not specifically publicly disclosed, Inova's Code of Conduct is on the public website. Section III of the Code of Conduct describes what can constitute a conflict and requires that potential conflicts be reported to management or the Chief Compliance Officer. The Code also refers to the conflict of interest policy which is available to staff and physicians on Inova's intranet website.”

“The organization falls under a master pay agent and does not file any payroll returns under its own EIN.”

“The company is part of the Inova Health System, a not-for-profit integrated health care delivery system serving Northern Virginia and surrounding areas. The company's financial statements are consolidated in the Inova Health System consolidated financial statements. Inova Health System is audited on an annual basis by a large "Big Four" independent public accounting firm. In addition, they are responsible for the issuance of a management letter encompassing each member of the consolidated group. The Audit and Compliance Committee of the Board of Trustees of Inova Health System is responsible for the oversight of the audit, including the hiring of the audit firm, review and approval of audited financial statements and communication with the external auditors at least twice a year without the presence of internal management.”

“The company is a subsidiary of the Inova Health System (IHS), a not-for-profit integrated health care delivery system serving Northern Virginia and surrounding areas. IHS receives various federal grants. These grants and awards are audited as part of the consolidated Inova Health System A-133 compliance audit. The Inova Health System's federal grants are audited on an annual basis by a large "Big Four" independent public accounting firm and a "Report on Compliance with Requirements Applicable to Each Major Program and on Internal Controls over Compliance in Accordance with OMB Circular A-133" is issued on a consolidated basis. The Audit and Compliance Committee of the Board of Trustees of Inova Health System is responsible for the oversight of the A-133 audit, including the hiring of the audit firm, review and approval of audited financial statements and communications with the external auditors at least twice a year without the presence of internal management.”